Literature DB >> 24751789

Adrenaline, terlipressin, and corticoids versus adrenaline in the treatment of experimental pediatric asphyxial cardiac arrest.

Rafael González1, Javier Urbano, Marta Botrán, Jorge López, Maria J Solana, Ana García, Sarah Fernández, Jesús López-Herce.   

Abstract

OBJECTIVE: To analyze if treatment with adrenaline (epinephrine) plus terlipressin plus corticoids achieves higher return of spontaneous circulation than adrenaline in an experimental infant animal model of asphyxial cardiac arrest.
DESIGN: Prospective randomized animal study.
SETTING: Experimental department in a University Hospital.
SUBJECTS: Forty-nine piglets were studied.
INTERVENTIONS: Cardiac arrest was induced by at least 10 minutes of removal of mechanical ventilation and was followed by manual external chest compressions and mechanical ventilation. After 3 minutes of resuscitation, piglets that did not achieve return of spontaneous circulation were randomized to two groups: adrenaline 0.02 mg kg every 3 minutes (20 animals) and adrenaline 0.02 mg kg every 3 minutes plus terlipressin 20 μg kg every 6 minutes plus hydrocortisone 30 mg kg one dose (22 animals). Resuscitation was discontinued when return of spontaneous circulation was achieved or after 24 minutes. MEASUREMENT AND MAIN
RESULTS: Return of spontaneous circulation was achieved in 14 piglets (28.5%), 14.2% with only cardiac massage and ventilation. Return of spontaneous circulation was achieved in 25% of piglets treated with adrenaline and in 9.1% of those treated with adrenaline plus terlipressin plus hydrocortisone (p = 0.167). Return of spontaneous circulation was achieved in 45.4% of animals with pulseless electric activity, 20% with asystole, and 0% with ventricular fibrillation (p = 0.037). Shorter duration of cardiac arrest, higher mean blood pressure and EtCO2 and lower PaCO2 before resuscitation, and higher mean blood pressure during resuscitation were associated with higher return of spontaneous circulation.
CONCLUSIONS: Treatment with adrenaline plus terlipressin plus corticoids does not achieve higher return of spontaneous circulation than that with adrenaline in an infant animal model of asphyxial cardiac arrest.

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Year:  2014        PMID: 24751789     DOI: 10.1097/PCC.0000000000000127

Source DB:  PubMed          Journal:  Pediatr Crit Care Med        ISSN: 1529-7535            Impact factor:   3.624


  4 in total

1.  A hemodynamic-directed approach to pediatric cardiopulmonary resuscitation (HD-CPR) improves survival.

Authors:  Ryan W Morgan; Todd J Kilbaugh; Wesley Shoap; George Bratinov; Yuxi Lin; Ting-Chang Hsieh; Vinay M Nadkarni; Robert A Berg; Robert M Sutton
Journal:  Resuscitation       Date:  2016-12-05       Impact factor: 5.262

2.  The physiologic response to rescue therapy with vasopressin versus epinephrine during experimental pediatric cardiac arrest.

Authors:  Julia C Slovis; Ryan W Morgan; William P Landis; Anna L Roberts; Alexandra M Marquez; Constantine D Mavroudis; Yuxi Lin; Tiffany Ko; Vinay M Nadkarni; Robert A Berg; Robert M Sutton; Todd J Kilbaugh
Journal:  Resusc Plus       Date:  2020-11-25

3.  Different Respiratory Rates during Resuscitation in a Pediatric Animal Model of Asphyxial Cardiac Arrest.

Authors:  Jorge López; Sarah N Fernández; Rafael González; María J Solana; Javier Urbano; Jesús López-Herce
Journal:  PLoS One       Date:  2016-09-12       Impact factor: 3.240

4.  Comparison between manual and mechanical chest compressions during resuscitation in a pediatric animal model of asphyxial cardiac arrest.

Authors:  Jorge López; Sarah N Fernández; Rafael González; María J Solana; Javier Urbano; Blanca Toledo; Jesús López-Herce
Journal:  PLoS One       Date:  2017-11-30       Impact factor: 3.240

  4 in total

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