OBJECTIVE: Experimental and clinical studies have implicated that alpha1- and beta-adrenergic effects of epinephrine significantly increased the severity of postresuscitation myocardial dysfunction by increasing myocardial oxygen consumption during ventricular fibrillation. This prompted experimental studies to investigate the effect of simultaneous blockade of alpha1- and beta-actions of epinephrine during cardiopulmonary resuscitation. DESIGN: Literature review. RESULTS: Improved postresuscitation myocardial dysfunction was observed in epinephrine-treated animals after its alpha1- and beta-actions were blocked, which were associated with less postresuscitation arrhythmia, lower blood lactate level, better neurologic recovery, and longer duration of survival. CONCLUSIONS: After simultaneous alpha1- and beta-adrenergic blockade, epinephrine administered during cardiopulmonary resuscitation yielded improved postresuscitation myocardial functions and significantly better postresuscitation outcomes.
OBJECTIVE: Experimental and clinical studies have implicated that alpha1- and beta-adrenergic effects of epinephrine significantly increased the severity of postresuscitation myocardial dysfunction by increasing myocardial oxygen consumption during ventricular fibrillation. This prompted experimental studies to investigate the effect of simultaneous blockade of alpha1- and beta-actions of epinephrine during cardiopulmonary resuscitation. DESIGN: Literature review. RESULTS: Improved postresuscitation myocardial dysfunction was observed in epinephrine-treated animals after its alpha1- and beta-actions were blocked, which were associated with less postresuscitation arrhythmia, lower blood lactate level, better neurologic recovery, and longer duration of survival. CONCLUSIONS: After simultaneous alpha1- and beta-adrenergic blockade, epinephrine administered during cardiopulmonary resuscitation yielded improved postresuscitation myocardial functions and significantly better postresuscitation outcomes.
Authors: Valentine Léopold; Etienne Gayat; Romain Pirracchio; Jindrich Spinar; Jiri Parenica; Tuukka Tarvasmäki; Johan Lassus; Veli-Pekka Harjola; Sébastien Champion; Faiez Zannad; Serafina Valente; Philip Urban; Horng-Ruey Chua; Rinaldo Bellomo; Batric Popovic; Dagmar M Ouweneel; José P S Henriques; Gregor Simonis; Bruno Lévy; Antoine Kimmoun; Philippe Gaudard; Mir Babar Basir; Andrej Markota; Christoph Adler; Hannes Reuter; Alexandre Mebazaa; Tahar Chouihed Journal: Intensive Care Med Date: 2018-06-01 Impact factor: 17.440