Effect of Epinephrine Administered during Cardiopulmonary Resuscitation on Cerebral Oxygenation after Restoration of Spontaneous Circulation in a Swine Model with a Clinically Relevant Duration of Untreated Cardiac Arrest

Hyoung Youn Lee, Kamoljon Shamsiev, Najmiddin Mamadjonov, Yong Hun Jung, Kyung Woon Jeung, Jin Woong Kim, Tag Heo and Yong Il Min
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Hyoung Youn Lee: Trauma Center, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
Kamoljon Shamsiev: Department of Medical Science, Chonnam National University Graduate School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea
Najmiddin Mamadjonov: Department of Medical Science, Chonnam National University Graduate School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea
Yong Hun Jung: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
Kyung Woon Jeung: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
Jin Woong Kim: Department of Radiology, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea
Tag Heo: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea
Yong Il Min: Department of Emergency Medicine, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Korea

IJERPH, 2021, vol. 18, issue 11, 1-14

Abstract: Severe neurological impairment was more prevalent in cardiac arrest survivors who were administered epinephrine than in those administered placebo in a randomized clinical trial; short-term reduction of brain tissue O 2 tension (PbtO 2 ) after epinephrine administration in swine following a short duration of untreated cardiac arrest has also been reported. We investigated the effects of epinephrine administered during cardiopulmonary resuscitation (CPR) on cerebral oxygenation after restoration of spontaneous circulation (ROSC) in a swine model with a clinically relevant duration of untreated cardiac arrest. After 7 min of ventricular fibrillation, 24 pigs randomly received either epinephrine or saline placebo during CPR. Parietal cortex measurements during 60-min post-resuscitation period showed that the area under the curve (AUC) for PbtO 2 was smaller in the epinephrine group than in the placebo group during the initial 10-min period and subsequent 50-min period (both p < 0.05). The AUC for number of perfused cerebral capillaries was smaller in the epinephrine group during the initial 10-min period ( p = 0.005), but not during the subsequent 50-min period. In conclusion, epinephrine administered during CPR reduced PbtO 2 for longer than 10 min following ROSC in a swine model with a clinically relevant duration of untreated cardiac arrest.

Keywords: heart arrest; epinephrine; oxygen; hypoxia (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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