Endotracheal versus intravenous epinephrine during electromechanical dissociation with CPR in dogs

Ralston, Sandra H.; Tacker, Willis A.; Showen, Lee; Carter, Alice B.; Babbs, Charles F.

doi:10.1016/s0196-0644(85)80916-1

Cited by 127 publications

(19 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 Endotracheal tube administration often requires the use of higher drug doses (compared with IV), 8 which can create airway irritation and interfere with gas exchange.…”

Section: Discussionmentioning

confidence: 99%

“…However, the need for higher drug doses, problems related to particle size, and distribution of drug to the lung periphery can hinder the effectiveness and/or usefulness of this type of drug delivery. [7][8][9][10] Liquid ventilation (LV), while providing a revolutionary mode for respiratory support, has also been shown experimentally to be an effective alternative means for drug administration. [11][12][13] For example, priscoline and gentamicin have been delivered to the uninjured lung of full-term animals and preterm animals with respiratory distress syndrome more effectively in this way as compared with IV administration.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary Administration of Gentamicin During Liquid Ventilation in a Newborn Lamb Lung Injury Model

et al. 1997

View full text Add to dashboard Cite

ABSTRACT. Objectives. Newborns with pulmonary infection frequently present with acute lung injury leading to ventilation/perfusion abnormalities in which intravenous delivery of antibiotics to the lung can be suboptimal. Tidal liquid ventilation (TLV) has been shown to be an effective means for delivering drugs directly to the pulmonary system. The objective of this study was to compare, with lung injury, antibiotic delivery achieved by conventional techniques (gas ventilation and intravenous gentamicin) with that using pulmonary administration of drug (PAD) during TLV.Methods. Twelve newborn lambs with an acid lung injury were randomized to receive gentamicin either intravenously during gas ventilation or via PAD during TLV using LiquiVent (Alliance Pharmaceutical Corporation, San Diego, CA, and Hoechst-Marion Roussel, Bridgewater, NJ) perfluorochemical. Gentamicin (5 mg/ kg) was administered over 1 minute, and serum levels were obtained at 15-minute intervals. Arterial blood gases and pulmonary mechanics were measured. Ventilation efficiency index and arterial/alveolar oxygen ratio were calculated. Lung-tissue gentamicin levels were measured 4 hours after administration and corrected to dry weight.Results. Serum gentamicin levels were similar in both groups. Lung gentamicin levels ( g/g) were significantly higher for TLV. Also, TLV resulted in significantly more of the total delivered dose in the lung after 4 hours. Ventilation efficiency index and arterial/alveolar oxygen ratios were significantly higher for TLV.Conclusions. In this lung injury model, both methods achieved equivalent serum gentamicin levels with higher lung levels using PAD during TLV. This study suggests that TLV may provide an effective vehicle for gentamicin delivery in infants with severe pulmonary infection and ventilation/perfusion abnormalities. Pediatrics 1997; 100(5). URL: http://www.pediatrics.org/cgi/content/full/ 100/5/e5; perfluorochemical, liquid ventilation, gentamicin, newborn, lung injury, pulmonary administration of drug, antibiotic, intratracheal.

show abstract

“…3 Endotracheal tube administration often requires the use of higher drug doses (compared with IV), 8 which can create airway irritation and interfere with gas exchange.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Pulmonary Administration of Gentamicin During Liquid Ventilation in a Newborn Lamb Lung Injury Model

et al. 1997

View full text Add to dashboard Cite

show abstract

“…24 These studies have shown significant increases in regional myocardial blood flow, aortic diastolic pressure, cerebral blood flow, and ROSC in animals receiving 0.1 to 0.2 mg/kg as compared with those receiving 0.01 mg/kg of epinephrine. 22,[25][26][27][28][29] Furthermore, 2 series of pediatric inpatients experienced an improved rate of ROSC after receiving 0.2 mg/kg of epinephrine as the third dose during resuscitation. 4,30 However, there have been no large prospective clinical trials that established the effectiveness of HDE in cardiopulmonary arrest (CPA) of the pediatric patient.…”

mentioning

confidence: 99%

The Use of High-Dose Epinephrine for Patients With Out-of-Hospital Cardiopulmonary Arrest Refractory to Prehospital Interventions

Patterson¹,

Boenning²,

Klein³

et al. 2005

Pediatric Emergency Care

View full text Add to dashboard Cite

show abstract

“…Other investigators have used specially designed catheters for the injections; Ralston and colleagues used a catheter with a spray nozzle to produce a fine mist of the injected solution in the distal trachea and then dispersed the mist into the lungs by two or three large volume breaths [6]. Drugs are distributed more uniformly and more deeply into the lung and are absorbed more rapidly after aerosol inhalation than after tracheal injection [9].…”

Section: Discussionmentioning

confidence: 99%

Haemodynamic effects of tracheally administered adrenaline in anaesthetised patients

Kestin

McCrirrick

1995

Anaesthesia

View full text Add to dashboard Cite

SummaryTen patients undergoing arterial surgery in the leg received a combined general anaesthetic, which included muscle relaxation and intubation of the trachea, and a regional anaesthetic using a lumbar extradural catheter. The radial arterialpressure was measured. Key wordsSympathetic newous system; pharmacology, adrenaline. Lung; trachea.The guidelines for cardiopulmonary resuscitation from the European Committee for Resuscitation recommend giving adrenaline through a tracheal tube if access is not available intravenously, although they recognised that this method is unreliable 111. A previous study showed that adrenaline five times the effective dose given intravenously to anaesthetised patients through a tracheal tube had no haemodynamic effects [2]. This present study was carried out to determine the dose of adrenaline given into the trachea which has haemodynamic .effects similar to adrenaline administered intravenously. MethodsThe project was approved by the hospital ethics committee. Ten patients undergoing arterial surgery in the leg gave written informed consent to the study. Patients were not studied if they had angina, arrhythmias, or were taking adrenergic blocking drugs. Patients were premedicated with temazepam and anaesthesia was induced with alfentanil 10 pg.kg-' and thiopentone. Muscle relaxation was obtained with atracurium, the trachea intubated and the lungs ventilated with oxygen, nitrous oxide and isoflurane. The inspired concentration of isoflurane was adjusted to maintain the systolic arterial pressure between 90 and 120 mmHg. A lumbar extradural catheter was inserted at Lw or L2-, and a test dose of 2 ml of 0.5% bupivacaine given. A further 8 ml of 0.5% bupivacaine was given in divided doses before surgery, followed by an infusion of 0.25% bupivacaine at 5 m1.h-l. The arterial pressure was measured with a 20G cannula in a radial artery and the arterial oxygen saturation by pulse oximetry. Muscle relaxation was maintained with an infusion of atracurium and adjusted to abolish the response to a supramaximal stimulus.After surgery had started and the systolic arterial pressure was stable between 90 and 120mmHg, 0.1 pg.kg-' adrenaline was given into a fast flowing intravenous infusion. The heart rate, arterial pressure and arterial saturation were recorded every 15 s for 10 min by an independent observer unaware of the purpose of the study. The maximum increase in the systolic arterial pressure was noted after the injection of adrenaline. Ten minutes after the injection, a series of tracheal injections of adrenaline in increasing doses was given. Each injection was diluted to 5 ml with normal saline, and injected down a catheter with the tip at the end of the tracheal tube and the lungs were manually inflated with five

show abstract

Endotracheal versus intravenous epinephrine during electromechanical dissociation with CPR in dogs

Cited by 127 publications

References 20 publications

Pulmonary Administration of Gentamicin During Liquid Ventilation in a Newborn Lamb Lung Injury Model

Pulmonary Administration of Gentamicin During Liquid Ventilation in a Newborn Lamb Lung Injury Model

The Use of High-Dose Epinephrine for Patients With Out-of-Hospital Cardiopulmonary Arrest Refractory to Prehospital Interventions

Haemodynamic effects of tracheally administered adrenaline in anaesthetised patients

Contact Info

Product

Resources

About