Developing a Vasopressor Combination in a Pig Model of Adult Asphyxial Cardiac Arrest

Abstract

Background-The purpose of this study was to investigate the effects of vasopressin versus epinephrine, and both drugs combined, in a porcine model of simulated adult asphyxial cardiac arrest. Methods and Results-At Ϸ7 minutes after the endotracheal tube had been clamped, cardiac arrest was present in 24 pigs and remained untreated for another 8 minutes. After 4 minutes of basic life support cardiopulmonary resuscitation, pigs were randomly assigned to receive, every 5 minutes, either epinephrine (

Employing vasopressin as an adjunct vasopressor in uncontrolled traumatic hemorrhagic shock

“…4 h) surgical management may result in poor outcome; second, similar to previous experience in the laboratory [6] and the critical care unit [4], vasopressin may be simply more potent than catecholamines when shock and acidosis are profound [8]. Moreover, in a setting of fundamental ischemia, observations in the CPR laboratory [9] and during in-hospital [8] and out-of-hospital CPR [8], suggest that vasopressin may be especially potent in combination with catecholamines. This hypothesis may be affirmed by our third case, when a vasopressin infusion was started in addition to a norepinephrine infusion when systolic arterial pressure was ca.…”

Effect of the Addition of Vasopressin or Vasopressin Plus Nitroglycerin to Epinephrine on Arterial Blood Pressure during Cardiopulmonary Resuscitation in Humans

“…The three successive administrations of study drugs every 5 min and the dose of nitroglycerin were adapted from two previous animal studies (pigs) in cardiac arrest (14,17). Additional interventions such as the administration of sodium bicarbonate, atropine, lidocaine, or amiodarone and fibrinolysis were used at the discretion of the physician managing the CPR.…”

Vasopressin and epinephrine versus epinephrine in management of patients with cardiac arrest: a meta-analysis

“…(21) Combining both drugs may combine both beneficial effects and avoid complications of injecting excessive dosages of one drug alone. In a series of animal studies, the group of subjects that received vasopressin and epinephrine appeared to have a more rapid rise in coronary perfusion pressure, (24) higher levels of left ventricular myocardial blood flow during CPR, (25) higher resuscitation rates, and improved cerebral blood flow (25,26,27) than the group that received epinephrine only, perhaps because of a synergistic effect of epinephrine and vasopressin. (28)(29)(30) Two previous meta-analyses have investigated whether vasopressin is superior to epinephrine in the management of cardiac arrest.…”