Resuscitation from cardiac arrest in cats: influence of epinephrine dosage on brain recovery

The quality of brain recovery after cardiac arrest depends crucially on the speed of cardiac resuscitation because the low cerebral perfusion pressure during the resuscitation procedure facilitates the development of no-reflow. To accelerate return of spontaneous circulation, high dose epinephrine h...

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Bibliographic Details
Published in:Resuscitation 1995-12, Vol.30 (3), p.251-262
Main Authors: Schmitz, Bernd, Fischer, Matthias, Bockhorst, Kurt, Hoehn-Berlage, Mathias, Hossmann, Konstantin-Alexander
Format: Article
Language:English
Subjects:
Animals
Body Water - metabolism
Brain - drug effects
Brain - physiopathology
Brain recovery
Cardiac arrest
Cat
Cats
Diffusion
Diffusion-weighted imaging
Dose-Response Relationship, Drug
Epinephrine
Epinephrine - administration & dosage
Epinephrine - therapeutic use
Heart Arrest - physiopathology
Heart Arrest - therapy
Magnetic Resonance Spectroscopy
Male
Resuscitation
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Summary:The quality of brain recovery after cardiac arrest depends crucially on the speed of cardiac resuscitation because the low cerebral perfusion pressure during the resuscitation procedure facilitates the development of no-reflow. To accelerate return of spontaneous circulation, high dose epinephrine has been recommended but the effect on the dynamics of early brain recovery is still unknown. We, therefore, studied the dynamics of brain resuscitation after cardiopulmonary resuscitation (CPR) with standard and high dose epinephrine using non-invasive NMR techniques. Fifteen min cardiac arrest was induced in normothermic cats by ventricular fibrillation. CPR was performed using an inflatable pneumatic vest for cyclic chest compression. With the beginning of CPR the standard dose group received 0.02 mg/kg epinephrine ( n = 6) and the high dose group received 0.2 mg/kg ( n = 8). Brain recovery was monitored by magnetic resonance imaging of the apparent diffusion coefficient (ADC) of water for 3 h. Although high dose epinephrine treatment led to a significantly higher blood pressure during early reperfusion, rapidly changing heterogeneities of early brain recovery were observed in both groups. High dose epinephrine thus does not improve the quality of post-cardiac arrest brain recovery during the first 3 h of reperfusion.
ISSN:0300-9572
1873-1570
DOI:10.1016/0300-9572(95)00891-8