Abstract
We measured cerebral (CBF) and myocardial (MBF) blood flow during cardiopulmonary resuscitation (CPR) in two week old swine to determine whether 10 fold increments of infused epinephrine (EPI) would progressively enhance CBF and MBF. CPR was performed for 50 min on pentobarbital anesthetized, 3.5 - 6 kg swine with a pneumatic compressor at 100 compressions/min, 60% duty cycle and 1:5 breath to compression ratio. In groups 1, 2 and 3 (n=4), EPI was administered first as a bolus (0, 1, 10 ug/kg, respectively) and then continuously (0, 1, 10 ug/kg/min respectively). Plasma EPI (ng/ml) (HPLC) rose from pre-arrest levels of <1 to 38±25, and 92±17, and 1627±231 (±SE) at 10 min in groups 1, 2, and 3 respectively. At 10 min, CBF (ml/min/100gm) (microspheres) was 17±10 (±SE), 32 ± 8 and 34±4 and cerebral 02 uptake (CMRO2) (ml/min/100gm) was 1.2±.7, 2.0 ± .2 and 2.1±.4 in groups 1, 2 and 3 respectively. MBF was 3±2, 20±13, and 48±7 in groups 1, 2 and 3 respectively (p <.05 between group 3 and 2). CBF, MBF, their respective perfusion pressures and CMRO2 progressively decreased with prolonged CPR. We conclude that in this infant CPR model, infusing 1 ug/kg/min EPI improves MBF, CBF and CMRO2. Increasing the dose to 10 ug/kg/min further elevates MBF, but has less incremental effect on CBF and CMRO2. Supported by NS 20020.
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Berkowitz, I., Koehler, R., Schleien, C. et al. CEREBRAL AND MYOCARDIAL BLOOD FLOW RESPONSE TO INCREASING DOSES OF EPINEPHRINE DURING CARDIOPULMONARY RESUSCITATION IN INFANT SWINE. Pediatr Res 21 (Suppl 4), 197 (1987). https://doi.org/10.1203/00006450-198704010-00187
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DOI: https://doi.org/10.1203/00006450-198704010-00187