Stress Hormone Response during and after Cardiopulmonary Resuscitation

Lindner, Karl H.; Strohmenger, Hans U.; Ensinger, H.; Hetzel, W. D.; Ahnefeld, Friedrich Wilhelm; Georgieff, Michael

doi:10.1097/00000542-199210000-00008

Cited by 210 publications

(81 citation statements)

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“…55 The finding that endogenous vasopressin levels are greater in patients successfully resuscitated from sudden cardiac death than in nonsurvivors sparked interest in the use of vasopressin for this indication. 56 Experimentally, the use of vasopressin during cardiopulmonary collapse has demonstrated a more beneficial effect than epinephrine on cerebral and myocardial blood flow, 57 resulting in more sustained increases in MAP. 58 Clinically, its use has been associated with a higher rate of short-term survival in patients experiencing out-of-hospital ventricular fibrillation.…”

Section: Cardiopulmonary Arrestmentioning

confidence: 99%

Inotropes and Vasopressors

2008

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Section: Cardiopulmonary Arrestmentioning

confidence: 99%

Inotropes and Vasopressors

2008

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“…Vasopressin was first proposed as a resuscitation agent after endogenous vasopressin levels were found to be higher in successfully resuscitated patients compared with those who died (13). Evidence from a large, adult, multicenter, randomized controlled trial suggests it to be superior to epinephrine, when the nature of the CA was primary asystole (14).…”

mentioning

confidence: 99%

Vasopressin improves survival compared with epinephrine in a neonatal piglet model of asphyxial cardiac arrest

et al. 2014

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Background: Epinephrine is a component of all resuscitation algorithms. Vasopressin is a pulmonary vasodilator and systemic vasopressor. We investigated the effect of epinephrine vs. vasopressin on survival and hemodynamics after neonatal porcine cardiac arrest (CA). Methods: A 4-min asphyxial CA was induced, after which cardiopulmonary resuscitation (CPR) was commenced. Animals were randomized to low-(LDE: 0.01 mg/kg) or high-dose epinephrine (HDE: 0.03 mg/kg), low-(LDV: 0.2 U/kg) or high-dose vasopressin (HDV: 0.4 U/kg), or control (saline). Clinical and echocardiography indexes were monitored. results: Sixty-nine animals were randomized. Survival was greater in HDV (n = 8 (89%); P < 0.05 ANOVA) vs. control (n = 7 (43%)) and LDE (n = 5 (36%)) but not vs. HDE (n = 7 (64%)) or LDV (n = 6 (75%)). Animals resuscitated with LDE required more shocks (2.5 (interquartile range: 2-6); P < 0.05) and higher doses of energy (15 J (interquartile range: 10-20); P < 0.05). Left ventricular output was comparable between groups, but a greater increase in superior vena caval flow was seen after HDV (P < 0.001 vs. control, LDE, and HDE). Plasma troponin was greatest in the HDE group (P < 0.05 vs. control and HDV). conclusion: Vasopressin results in improved survival, lower postresuscitation troponin, and less hemodynamic compromise after CA in newborn piglets. Vasopressin may be a candidate for testing in human neonates. t he need for active neonatal resuscitation is common with an incidence of 5-10%, although there is likely to be regional variability (1). Guidelines for drug use in neonatal resuscitation guidelines are based on extrapolations from adult literature. Pressors, almost invariably epinephrine, are recommended as core therapy during cardiopulmonary resuscitation (CPR) in order to enhance systemic perfusion (especially cerebral and coronary perfusion) by maintaining vascular tone while forward flow is generated by chest compressions. Epinephrine, although an integral part of every published protocol for neonatal resuscitation, may be associated with adverse effects (2-6); similar concerns exist in pediatric and adult cardiac arrest (CA). However, because of concerns associated with epinephrine (2,7), vasopressin was studied in the setting of asystolic CA. Vasopressin is an intense systemic vasoconstrictor, which may explain why it increases cerebral (and systemic) perfusion during experimental cardiac massage, as well as increasing cerebral oxygenation, neurological outcome, and resuscitation success following experimental .Vasopressin was first proposed as a resuscitation agent after endogenous vasopressin levels were found to be higher in successfully resuscitated patients compared with those who died (13). Evidence from a large, adult, multicenter, randomized controlled trial suggests it to be superior to epinephrine, when the nature of the CA was primary asystole (14). For the following reasons, vasopressin may be a good candidate for pressor support during CPR. First, CA in neonates is almost always due to asphy...

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“…32 The importance of AVP has also been described in cardiovascular shock states. 15,33,34 It should be noted that the significance of the role of the concentration of copeptin has also been observed in other diseases that worsen the prognosis of cardiovascular events, namely: chronic obstructive pulmonary disease; 35 40 and the prediction of mortality after injury of the central nervous system. 41 Copeptin concentration is also an important marker of the progression of renal dysfunction, as measured by the glomerular filtration rate (GFR) index.…”

Section: Copeptin In Cardiovascular and Kidney Diseasesmentioning

confidence: 96%

Copeptin in heart failure

Lasota¹,

Mizia-Stec²

2014

RRCC

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Abstract:Copeptin is a novel indicator of arginine-vasopressin activation in the body. Its value has primarily been documented in acute life-threatening conditions mediated by the stress response system. Recently, some studies have revealed copeptin's promising role as a marker in cardiovascular diseases. In our review, we summarize the current knowledge on copeptin in pathophysiology, as well as in risk assessment in different clinical settings involving the cardiovascular system with a special focus on heart failure.

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Stress Hormone Response during and after Cardiopulmonary Resuscitation

Cited by 210 publications

References 0 publications

Inotropes and Vasopressors

Inotropes and Vasopressors

Vasopressin improves survival compared with epinephrine in a neonatal piglet model of asphyxial cardiac arrest

Copeptin in heart failure

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