Abstract
After almost five decades of the so-called modern era of cardiopulmonary resuscitation (CPR) the survival percentage of patients affected by cardiac arrest is rarely above 5–6%. Post resuscitation myocardial dysfunction accounts for most deaths during the first 72 hours after the return of spontaneous circulation. When the heart stops beating, all cardiomyocytes undergo ischaemic damage, the severity of which increases with the duration of no flow, as previously demonstrated in experimental and clinical studies [1, 2].
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References
Tang W, Weil MH, Sun S et al (1999) The effect of biphasic and conventional monophasic defibrillation on post-resuscitation myocardial dysfunction. J Am Coll Cardiol 34:815–822
Schultz CH, Rivers EP, Feldkamp CS et al (1993) A characterization of hypothalamicpituitary-adrenal axis function during and after human cardiac arrest. Crit Care Med 21:1339–1347
Klouche K, Weil MH, Sun S et al (2002) Evolution of the stone heart after prolonged cardiac arrest. Chest 122:1006–1111
Tang W, Weil MH, Sun S et al (1995) Epinephrine increases the severity of post-resuscitation myocardial dysfunction. Circ 92:3089–3093
Ditchey RV, Lindenfeld J (1988) Failure of epinephrine to improve the balance between myocardial oxygen supply and demand during closed-chest resuscitation in dogs. Circulation 78:382–389
Jennings RB, Reimer KA, Steenbergen C (1986) Myocardial ischemia revisited: the osmolar load, membrane damage and perfusion. J Mol Cell Cardiol 18:769–780
Holmberg M, Holmberg S, Herlitz J (2002) Low chance of survival among patients requiring adrenaline (epinephrine) or intubation after out-of-hospital cardiac arrest in Sweden. Resuscitation 54:37–45
Laurent I, Monchi M, Chiche J et al (2002) Reversible myocardial dysfunction in survivors of out-of-hospital cardiac arrest. J Am Coll Cardiol 40:2110–2116
Gonzales ER, Ornato JP, Garnet AR et al (1989) Dose-dependent vasopressor response to phenylephrine during CPR in human beings. Ann Emerg Med 18:920–926
Fries M, Tang W, Chang YT et al (2004) Detrimental effects of epinephrine on microcirculatory blood flow in a porcine model of cardiac arrest. Crit Care Med 32:A56 [Abstract]
Fries M, Weil MH, Chang YT et al (2006) Microcirculation during cardiac arrest and resuscitation. Crit Care Med 34:S454–S457
Ristagno G, Sun S, Chang YT et al (2006) Epinephrine reduces cerebral microcirculatory blood flow during CPR. Crit Care Med 33:A24 [Abstract]
Ristagno G, Sun S, Tang W et al (2007) Effects of epinephrine and vasopressin on cerebral microcirculatory flows during and after cardiopulmonary resuscitation. Crit Care Med 35:2145–2149
Nichol G, Stiell IG, Laupacis A et al (1999) A cumulative meta-analysis of the effectiveness of defibrillator-capable emergency medical service for victims of out-of-hospital cardiac arrest. Ann Emeng Med 34:517–525
Stratton S, Niemann JT (1998) Effects of adding links to “the chain of survival” for prehospital cardiac arrest: a contrast in outcomes in 1975 and 1995 at a single institution. Ann Emeng Med 31:471–477
Lindner KH, Ahnefeld FW, Grunert A (1991) Epinephrine vs norepinephrine in pre-hospital ventricular fibrillation. Am J Cardiol 67:427–428
Callaham ML, Madsen CD, Barton CW et al (1992) A randomized clinical trial of high-dose of epinephrine and norepinephrine vs standard-dose of epinephrine in pre-hospital cardiac arrest. JAMA 268:2667–2672
Brillman JA, Sanders AB, Otto CW et al (1985) Outcome of resuscitation from fibrillatory arrest using epinephrine and phenylephrine in dogs. Crit Care Med 13:912–913
Brown CG, Taylor RB, Werman HA et al (1988) Myocardial oxygen delivery/consumption during cardiopulmonary resuscitation: a comparison of epinephrine and phenylephrine. Ann Emerg Med 17:302–308
Olson DW, Thakur R, Stueven HA et al (1989) Randomized study of epinephrine versus methoxamine in prehospital ventricular fibrillation. Ann Emerg Med 18:250–253
Brown CG, Birinyi F, Werman HA et al (1986) The comparative effect of epinephrine versus phenylephrine on regional cerebral blood flow during cardiopulmonary resuscitation. Resuscitation 14:171–183
Silfvast T, Saarnivaara L, Kinnunen A et al (1985) Comparison of epinephrine and phenylephrine in out-of-hospital cardiopulmonary resuscitation: a double-blind study. Acta Anaesthesiol Scand 29:610–616
Klouche K, Weil MH, Tang W et al (2002) A selective alpha2-adrenergic agonist for cardiac resuscitation. J Lab Clin Med 140:27–34
Klouche K, Weil MH, Sun S et al (2003) A comparison of alpha-methylnorepinephrine, vasopressin and epinephrine for cardiac resuscitation. Resuscitation 57:93–100
Gold HK, Leinbach RC, Maroko PR (1976) Propranolol-induced reduction of signs of ischemic injury during acute myocardial infarction. Am J Cardiol 38:689–695
Maroko PR, Libby P, Covell JW et al (1972) Precordial S-T elevation mapping: an atraumatic method for assessing alteration in the extent of myocardial ischemic injury. Am J Cardiol 29:223–230
Obeid A, Spear R, Mookherjee S et al (1976) The effect of propranolol on myocardial energy stores during myocardial ischemia in dogs. Circ Suppl 11:11–159 [Abstract]
Ditchey RV, Rubio-Perez A, Slinker BK (1994) Beta-adrenergic blockade reduces myocardial injury during experimental cardiopulmonary resuscitation. J Am Coll Cardiol 24:804–812
Cammarata G, Weil MH, Sun S et al (2004) 1-adrenergic blockade during cardiopulmonary resuscitation improves survival. Crit Care Med 32:8440–8443
Sun S, Weil MH, Tang W et al (2001) alpha-Methylnorepinephrine, a selective alpha2-adrenergic agonist for cardiac resuscitation. J Am Coll Cardiol 37:951–956
Lindner KH, Haak T, Keller A et al (1996) Release of endogenous vasopressors during and after cardiopulmonary resuscitation. Heart 75:145–150
Wenzel V, Lindner KH, Krismer AC et al (1999) Repeated administration of vasopressin, but not epinephrine, maintains coronary perfusion pressure after early and late administration during prolonged cardiopulmonary resuscitation in pigs. Circulation 99:1379–1384
Wenzel V, Lindner KH, Krismer AC et al (2000) Survival with full neurologic recovery and no cerebral pathology after prolonged cardiopulmonary resuscitation with vasopressin in pigs J Am Coll Cardiol 35:527–533
Lindner KH, Prengel AW, Brinkmann A et al (1996) Vasopressin administration in refractory cardiac arrest. Ann Intern Med 124:1061–1064
Lindner KH, Dirks B, Strohmenger HU (1997) Randomized comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation Lancet 349:535–538
Stiell IG, Hebert PC, Wells GA et al (2001) Vasopressin vs epinephrine for in-hospital cardiac arrest: a randomized controlled trial. Lancet 358:105–109
Wenzel V, Lindner KH (2001) Vasopressin and epinephrine for cardiac arrest. Lancet 358:2080–2081
Wenzel V, Krismer AC, Arntz HR et al (2004) A comparison of vasopressin and epinephrine for out-of hospital cardiopulmonary resuscitation. N Engl J Med 350:105–113
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Cammarata, G. (2008). Vasopressors During Cardiac Arrest. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-0773-4_20
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DOI: https://doi.org/10.1007/978-88-470-0773-4_20
Publisher Name: Springer, Milano
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