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CRITICAL CARE AND TRAUMA

A Comparison of Distilled Water and Normal Saline as Diluents for Endobronchial Administration of Epinephrine in the Dog

Department of Veterinary Science, Faculty of Agriculture, Miyazaki University, Miyazaki, Japan

Address correspondence and reprint requests to Kiyokazu Naganobu, BVSc, Department of Veterinary Science, Faculty of Agriculture, Miyazaki University, Miyazaki 889-2192, Japan. Address e-mail to a0e303u{at}cc.miyazaki-u.ac.jp

We compared the effects of distilled water and normal saline as diluents for the endobronchial administration of epinephrine in anesthetized dogs by using a cross-over design. Six dogs received 2 mL of either normal saline or distilled water into the bronchus, and the other solution was administered 1 wk later. Eight dogs received 0.02 mg/kg epinephrine diluted in either distilled water (E + water) or normal saline (E + saline) to a total volume of 2 mL into the bronchus, and the other solution was administered 1 wk later. Normal saline or distilled water without epinephrine did not affect the plasma epinephrine concentration, mean arterial pressure (MAP), and PaO₂. The peak plasma epinephrine concentration was significantly larger after treatment with E + water (26.5 ± 7.9 ng/mL) than after E + saline (2.1 ± 0.7 ng/mL). E + water caused an increase in MAP of 91 ± 24 mm Hg, whereas E + saline did not affect MAP. The maximal decrease in PaO₂ after the administration of E + water (14 ± 5 mm Hg) was significantly greater than after E + saline (7 ± 2 mm Hg). In conclusion, distilled water as the diluent for endobronchially administered epinephrine to a total volume of 2 mL allowed better absorption of epinephrine compared with normal saline without a serious detrimental effect on PaO₂.

Implications: Using a small volume of distilled water as the diluent for endobronchial epinephrine administration significantly increased epinephrine absorption and arterial pressure in comparison with normal saline, without having a serious detrimental effect on PaO₂, in an anesthetized, noncardiopulmonary, resuscitation dog model.

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