Milrinone combined with vasopressin improves cardiac index after cardiopulmonary resuscitation in a pig model of myocardial infarction

Milrinone used for acute cardiac insufficiency could be of interest during cardiopulmonary resuscitation because of its positive inotropic effects. In this study, the combination of milrinone-vasopressin was compared with epinephrine and vasopressin, as well as with the combination of epinephrine-va...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 2007, Vol.106 (1), p.100-106
Main Authors: PALMAERS, Thomas, ALBRECHT, Sven, HEUSER, Fabian, LEUTHOLD, Christian, SCHUETTLER, Juergen, SCHMITZ, Bernd
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Animals
Biological and medical sciences
Blood Pressure - drug effects
Cardiopulmonary Resuscitation
Coronary Circulation - drug effects
Disease Models, Animal
Drug Therapy, Combination
Male
Medical sciences
Milrinone - administration & dosage
Myocardial Infarction - therapy
Phosphodiesterase Inhibitors - administration & dosage
Swine
Vasopressins - administration & dosage
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Summary:Milrinone used for acute cardiac insufficiency could be of interest during cardiopulmonary resuscitation because of its positive inotropic effects. In this study, the combination of milrinone-vasopressin was compared with epinephrine and vasopressin, as well as with the combination of epinephrine-vasopressin, in reference to hemodynamics. Thirty-two pigs underwent ligation of the circumflex coronary artery and induction of ventricular fibrillation lasting for 4 min. Cardiopulmonary resuscitation was performed after randomization to one of four groups: epinephrine (30-microg/kg bolus), vasopressin (0.4-U/kg bolus), epinephrine-vasopressin (15-microg/kg epinephrine bolus, 0.2-U/kg vasopressin bolus), or milrinone-vasopressin (0.4-U/kg vasopressin bolus, 50-microg/kg milrinone bolus over 5 min and a continuous infusion of 0.4 microg.kg.min). The hemodynamic variables were measured before cardiopulmonary resuscitation as well as 4, 8, 15, and 30 min after return of spontaneous circulation. All animals were resuscitated successfully. The animals of the milrinone-vasopressin group displayed significantly (P
ISSN:0003-3022
1528-1175
DOI:10.1097/00000542-200701000-00018