Vasopressin and epinephrine in the treatment of cardiac arrest: an experimental study

Konstantinos Stroumpoulis , Theodoros Xanthos , Georgios Rokas , Vassiliki Kitsou , Dimitrios Papadimitriou , Ioannis Serpetinis , Despina Perrea , Lila Papadimitriou and Evangelia Kouskouni

University of Athens, Medical School, Department of Experimental Surgery and Surgical Research, Agiou Thoma Street, Athens, Greece

author email corresponding author email

Critical Care 2008, 12:R40doi:10.1186/cc6838


Published:	14 March 2008

See related commentary by Oranto, http://ccforum.com/content/12/2/123

Abstract

Background

Epinephrine remains the drug of choice for cardiopulmonary resuscitation. The aim of the present study is to assess whether the combination of vasopressin and epinephrine, given their different mechanisms of action, provides better results than epinephrine alone in cardiopulmonary resuscitation.

Methods

Ventricular fibrillation was induced in 22 Landrace/Large-White piglets, which were left untreated for 8 minutes before attempted resuscitation with precordial compression, mechanical ventilation and electrical defibrillation. Animals were randomized into 2 groups during cardiopulmonary resuscitation: 11 animals who received saline as placebo (20 ml dilution, bolus) + epinephrine (0.02 mg/kg) (Epi group); and 11 animals who received vasopressin (0.4 IU/kg/20 ml dilution, bolus) + epinephrine (0.02 mg/kg) (Vaso-Epi group). Electrical defibrillation was attempted after 10 minutes of ventricular fibrillation.

Results

Ten of 11 animals in the Vaso-Epi group restored spontaneous circulation in comparison to only 4 of 11 in the Epi group (p = 0.02). Aortic diastolic pressure, as well as, coronary perfusion pressure were significantly increased (p < 0.05) during cardiopulmonary resuscitation in the Vaso-Epi group.

Conclusion

The administration of vasopressin in combination with epinephrine during cardiopulmonary resuscitation results in a drastic improvement in the hemodynamic parameters necessary for the return of spontaneous circulation.