Combination pharmacotherapy in the treatment of experimental cardiac arrest.

Full Abstract

STUDY OBJECTIVES: Full recovery after cardiopulmonary resuscitation (CPR) is poor. We hypothesized that the coadministration of epinephrine, a beta-blocker such as atenolol, and a calcium sensitizer such as levosimendan during CPR would improve survival and postresuscitation myocardial function. METHODS: Ventricular fibrillation was induced in 60 piglets, which were left untreated for 8 minutes before attempted resuscitation. Animals were randomized into 4 groups (n = 15), to receive epinephrine (group E), epinephrine + atenolol (group E + A), epinephrine + levosimendan (group E + L) and epinephrine + atenolol + levosimendan (group E + A + L) during CPR. Electrical defibrillation was attempted 2 minutes after drug administration. RESULTS: Five animals in group E survived for 48 hours in comparison to 8 animals in groups E + A and E + L and 12 animals in group E + A + L. Postresuscitation cardiac output was significantly better in the animals of group E + A + L. Troponin I remained significantly lower in groups E + A and E + A + L. Serum astroglial protein (S-100) and neuron-specific enolase values in group E + L and E + A + L were statistically lower than those measured in groups E and E + A during the entire observation period. The neurologic alertness score was higher in group E + A + L compared to groups E and E + A. CONCLUSIONS: The administration of a drug combination of epinephrine + atenolol + levosimendan, when given during CPR, in a pig model of cardiac arrest, results in improved 48-hour survival and improves postresuscitation cardiac function.

Author information

Author/s: Xanthos, Theodoros (T); Bassiakou, Eleni (E); Koudouna, Eleni (E); Rokas, Georgios (G); Goulas, Sotirios (S); Dontas, Ismene (I); Kouskouni, Evaggelia (E); Perrea, Despina (D); Papadimitriou, Lila (L);

Affiliation: Department of Experimental Surgery and Surgical Research, University of Athens, Medical School, 11527 Athens, Greece. theodorosxanthos(-atsign-)yahoo.com

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: The American journal of emergency medicine (Am J Emerg Med), published in United States. (Language: eng)

Reference: 2009-Jul; vol 27 (issue 6) : pp 651-9

Dates: Created 2009/09/15; Completed 2009/10/08;

PMID: 19751621, status: MEDLINE (last retrieved date: 10/8/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Adrenergic beta-Agonists - therapeutic use
Animals
Atenolol - therapeutic use
Cardiotonic Agents - therapeutic use
Disease Models, Animal
Drug Therapy, Combination
Epinephrine - therapeutic use
Heart Arrest - drug therapy

Note: Bold headings indicate primary MeSH headings or qualifiers.

Associated Chemicals: Adrenergic beta-Agonists (0) ; Cardiotonic Agents (0) ; Hydrazones (0) ; Pyridazines (0) ; S100 Proteins (0) ; Troponin I (0) ; simendan (131741-08-7) ; Atenolol (29122-68-7) ; Lactic Acid (50-21-5) ; Epinephrine (51-43-4) ; Phosphopyruvate Hydratase (EC 4.2.1.11)

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