Effect of adrenergic drugs on cerebral blood flow, metabolism, and evoked potentials after delayed cardiopulmonary resuscitation in dogs.

Abstract

Background and Purpose: Epinephrine administration during cardiopulmonary resuscitation increases cerebral blood flow by increasing arterial pressure. We tested whether potential /3-adrenergic effects of epinephrine directly influence cerebral blood flow and oxygen consumption independently of raising perfusion pressure.Methods: Four groups of seven anesthetized dogs were subjected to 8 minutes of fibrillatory arrest followed by 6 minutes of chest compression, ventricular defibrillation, and 4 hours of spontaneous circulation. Cerebral perfusion pressure was increased to approximately equivalent ranges during resuscitation by either 1) epinephrine infusion, 2) epinephrine infusion after pretreatment with the lipophylic /3-adrenergic antagonist pindolol, 3) infusion of the a-adrenergic agonist phenylephrine, or 4) descending aortic balloon inflation without pressor agents.Results: We found no difference in cerebral blood flow, oxygen extraction, or oxygen consumption during chest compression among groups. After ventricular defibrillation, depressed levels of cerebral blood flow, cerebral oxygen consumption, and somatosensory evoked potential amplitude were not different among groups.Conclusions: We detected no evidence that after 8 minutes of complete ischemia, epinephrine administration during resuscitation substantially influences cerebral blood flow or cerebral oxygen consumption independent of its action of raising arterial pressure or that epinephrine has a negative impact on immediate metabolic or electrophysiological recovery attributable to its /3-adrenergic activity. (Stroke 1991;22:1554-1561)

Somatosensory Evoked Potential and Brain Water Content in Post-Asphyxic Immature Piglets

“…The dose of epinephrine chosen in this study has been shown to improve myocardial and cerebral blood flow during CPR in immature piglets (18,30). In addition, epinephrine does not appear to have central effects that might improve SEP independent of improving cerebral blood flow (20,31). Cerebral edema is usually described as either cytotoxic or vasogenic to refer to two different mechanisms.…”

Correlation of EEG-based brain resuscitation index and end-tidal carbon dioxide in porcine cardiac arrest model

“…Fourth, epinephrine was not used during the experiment. Epinephrine is known to elevate CoPP and have a temporary cerebral vasoconstriction effect [41]. Epinephrine was not used to minimize its effect on EEG.…”

Association between Brain and Kidney Near-Infrared Spectroscopy and Early Postresuscitation Mortality in Asphyxiated Newborn Piglets

“…Although Pichler et al [18] found that rSrO 2 may underestimate kidney hypoxia in newborn piglets, our results indicate that rSrO 2 is a more sensitive marker of detrimental hypoxic organ injury than rScO 2 . Gervais et al [19] demonstrated in dogs with ventricular fibrillation that brain and heart blood flow were better preserved during CPR than that of, for example, the kidney. After resuscitation, the kidney blood flow remained depressed, whereas blood flow to the other organs recovered.…”