Effect of the aminosteroid U74006F after cardiopulmonary arrest in dogs

• Published in: Stroke (1970) 1988-11, Vol.19 (11), p.1371-1378
• Main Authors: NATALE, J. E, SCHOTT, R. J, HALL, E. D, BRAUGHLER, J. M, D'ALECY, L. G
• Format: Article
• Language: English
• Subjects: Animals; Antianginal agents. Coronary vasodilator agents; Biological and medical sciences; Cardiovascular system; Dogs; Heart Arrest - complications; Ischemic Attack, Transient - drug therapy; Ischemic Attack, Transient - etiology; Ischemic Attack, Transient - therapy; Lipid Peroxides - antagonists & inhibitors; Lipid Peroxides - blood; Male; Medical sciences; Nervous System Diseases - etiology; Nervous System Diseases - physiopathology; Osmolar Concentration; Pharmacology. Drug treatments; Pregnatrienes - blood; Pregnatrienes - therapeutic use; Resuscitation; Time Factors; Vitamin E - blood
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.19.11.1371

The oxygen free radical-induced lipid peroxidative reactions that occur during resuscitation from normothermic cardiac arrest may contribute to the degree of neurologic dysfunction sustained. A blinded, randomized experimental trial was performed to determine whether U74006F, a potent inhibitor of lipid peroxidation, reduces morbidity and 24-hour mortality after 10 minutes of normothermic cardiopulmonary arrest; ventricular fibrillation was induced by electrical stimulation in 24 open-chest, halothane-anesthetized dogs, and circulation was reestablished by direct cardiac compressions, administration of a standardized drug regime, and internal countershocks. When spontaneous circulation was restored, a bolus injection of 1.5 mg/kg U74006F (n = 12) or 25 mM citrate vehicle (n = 12) was infused intravenously in 15 minutes and an infusion was continued at 0.125 mg/kg/hr for the next 12 hours. In the drug-treated group, plasma U74006F concentration averaged 0.13 microgram/ml between 3 and 12 hours after cardiac arrest. By 24 hours after arrest, 10 of 12 (83%) vehicle-treated dogs had died but only four of 12 (33%) U74006F-treated dogs had died (p = 0.017). U74006F-treated dogs survived significantly longer (mean +/- SEM 22 +/- 1 hr) than vehicle-treated dogs (18 +/- 1 hr), with significantly better neurologic function 1, 2, and 24 hours after arrest. Plasma fatty acid hydroperoxide concentrations 12 hours after arrest were 88 +/- 81 pmol/ml in U74006F-treated and 241 +/- 49 pmol/ml in vehicle-treated dogs (p less than 0.05). Vitamin E concentrations were significantly higher in the plasma of U74006F-treated dogs 2, 3, and 6 hours after arrest compared with vehicle-treated dogs.