| JOURNAL HOME | CME HOME | THIS MONTH | PAST ISSUES | ETOC | COLLECTIONS |
| AUTHORS | REVIEWERS | EDITORIAL BOARD | FEEDBACK | RSS | HELP |
| ||||||||||||||
| ||||||||||||||
|
|
|
|
||||||||||||
|
||||||||||||||
*Department of Anesthesiology and Critical Care Medicine, Leopold-Franzens-University of Innsbruck, Innsbruck, Austria; and the
Cardiac Arrhythmia Center, Cardiovascular Division, Department of Medicine, University of Minnesota, Minneapolis, Minnesota
Address correspondence and reprint requests to Anton Amann, PhD, The Leopold-Franzens University of Innsbruck, Department of Anesthesiology and Critical Care Medicine, Anichstrasse 35, 6020 Innsbruck, Austria. Address e-mail to anton.amann{at}uibk.ac.at
This study evaluated ventricular fibrillation mean frequency and amplitude to predict defibrillation success in a porcine cardiopulmonary resuscitation (CPR) model using repeated administration of vasopressin or epinephrine. After 4 min of cardiac arrest and 3 min of CPR, 10 pigs were randomly assigned to receive either vasopressin (early vasopressin: 0.4, 0.4, and 0.8 units/kg, respectively, n = 5) or epinephrine (early epinephrine: 45, 45, and 200 µg/kg, respectively, n = 5). Another 11 animals were randomly allocated after 4 min of cardiac arrest and 8 min of CPR to receive every 5 min either vasopressin (late vasopressin: 0.4 and 0.8 units/kg, respectively, n = 5) or epinephrine (late epinephrine: 45 and 200 µg/kg, n = 6). Ventricular fibrillation mean frequency and amplitude on defibrillation were significantly higher in the vasopressin groups than in the epinephrine groups, respectively. In vasopressin versus epinephrine animals, mean frequency immediately before defibrillation was 9.6 ± 1.5 Hz vs 7.0 ± 0.7 Hz (P < 0.001), mean amplitude was 0.65 ± 0.26 mV vs 0.21 ± 0.14 mV (P < 0.001, and coronary perfusion pressure was 27 ± 9 mm Hg vs 8 ± 4 mm Hg (P < 0.00001), respectively. In contrast to no epinephrine animals, all vasopressin animals were successfully defibrillated and survived 1 h (P < 0.05). Mean fibrillation frequency and amplitude predicted successful defibrillation and may serve as noninvasive markers to monitor continuing CPR efforts. Furthermore, vasopressin was superior to epinephrine in maintaining these variables above a threshold necessary for successful defibrillation.
Implications: Mean frequency and amplitude of ventricular fibrillation predicted successful defibrillation in pigs. Vasopressin was superior to epinephrine in maintaining these variables above a success defibrillation threshold.
This article has been cited by other articles:
|
|
 |
|
  J. H. Indik, R. W. Hilwig, M. Zuercher, K. B. Kern, M. D. Berg, and R. A. Berg Preshock Cardiopulmonary Resuscitation Worsens Outcome From Circulatory Phase Ventricular Fibrillation With Acute Coronary Artery Obstruction in Swine Circ Arrhythmia Electrophysiol, April 1, 2009; 2(2): 179 - 184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. D. Mentzelopoulos, S. G. Zakynthinos, M. Tzoufi, N. Katsios, A. Papastylianou, S. Gkisioti, A. Stathopoulos, A. Kollintza, E. Stamataki, and C. Roussos Vasopressin, Epinephrine, and Corticosteroids for In-Hospital Cardiac Arrest Arch Intern Med, January 12, 2009; 169(1): 15 - 24. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Heath, D. Hanson, R. Long, and N. A. Crowell Critical Care Providers' Perceptions of the Use of Vasopressin in Cardiac Arrest Am. J. Crit. Care., November 1, 2005; 14(6): 481 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Holzer, W. Behringer, F. Sterz, J. Kofler, E. Oschatz, E. Schuster, and A. N. Laggner Ventricular Fibrillation Median Frequency May Not Be Useful for Monitoring During Cardiac Arrest Treated with Endothelin-1 or Epinephrine Anesth. Analg., December 1, 2004; 99(6): 1787 - 1793. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. H. Stadlbauer, K. Rheinberger, V. Wenzel, C. Raedler, A. C. Krismer, H.-U. Strohmenger, S. Augenstein, H. G. Wagner-Berger, W. G. Voelckel, K. H. Lindner, et al. The Effects of Nifedipine on Ventricular Fibrillation Mean Frequency in a Porcine Model of Prolonged Cardiopulmonary Resuscitation Anesth. Analg., July 1, 2003; 97(1): 226 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Amann, K. Rheinberger, U. Achleitner, A. C. Krismer, W. Lingnau, K. H. Lindner, and V. Wenzel The Prediction of Defibrillation Outcome Using a New Combination of Mean Frequency and Amplitude in Porcine Models of Cardiac Arrest Anesth. Analg., September 1, 2002; 95(3): 716 - 722. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-U. Strohmenger, T. Eftestol, K. Sunde, V. Wenzel, M. Mair, H. Ulmer, K. H. Lindner, and P. A. Steen The Predictive Value of Ventricular Fibrillation Electrocardiogram Signal Frequency and Amplitude Variables in Patients with Out-Of-Hospital Cardiac Arrest Anesth. Analg., December 1, 2001; 93(6): 1428 - 1433. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. C. Krismer, Q. H. Hogan, V. Wenzel, K. H. Lindner, U. Achleitner, S. Oroszy, B. Rainer, A. Wihaidi, V. D. Mayr, P. Spencker, et al. The Efficacy of Epinephrine or Vasopressin for Resuscitation During Epidural Anesthesia Anesth. Analg., September 1, 2001; 93(3): 734 - 742. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. V. DiGregorio Pharmacotherapeutic Advances in Cardiac Resuscitation: A Review of the Advanced Cardiac Life Support (ACLS) 2000 Guidelines and Their Impact on Pharmacy Practice Journal of Pharmacy Practice, February 1, 2001; 14(1): 41 - 53. [Abstract] [PDF]
|
|
|
