George Karlis1,2, Nicoletta Iacovidou3,4, Pavlos Lelovas3, Panagiota Niforopoulou3, Apostolos Papalois5, Ioanna Siafaka6, Spyros Mentzelopoulos7, Theodoros Xanthos3,8,9. 1. 2nd Department of Internal Medicine, Sismanoglio General Hospital, Athens, Greece. georgekarlis@yahoo.com. 2. Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. georgekarlis@yahoo.com. 3. Hellenic Society of Cardiopulmonary Resuscitation, Athens, Greece. 4. 2nd Department of Obstetrics and Gynecology, Neonatal Division, Aretaieio Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece. 5. Experimental-Research Center ELPEN Pharmaceutical, Athens, Greece. 6. 1st Anesthesiology Clinic, Pain Relief and Palliative Care Unit, Aretaieio Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece. 7. 1st Department of Intensive Care Medicine, National and Kapodistrian University of Athens, Medical School, Athens, Greece. 8. MSc "Cardiopulmonary Resuscitation", National and Kapodistrian University of Athens, Medical School, Athens, Greece. 9. Midwestern University of Chicago, Chicago, IL, USA.
Abstract
PURPOSE: The purpose of the experiment was to compare the effects of nifekalant and amiodarone on the return of spontaneous circulation (ROSC), survival, as well as on the hemodynamic parameters in a swine model of prolonged ventricular fibrillation (VF). METHODS: After 8 min of untreated VF, bolus doses of epinephrine (adrenaline) and either nifekalant, or amiodarone, or saline (n = 10 per group), were administered after randomization. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration and defibrillation was attempted 2 min later. CPR was resumed for another 2 min after each defibrillation attempt and the same dose of adrenaline was given every 4th minute during CPR. RESULTS: Forty-eight hour survival was significantly higher with nifekalant compared to amiodarone (p < 0.001) and saline (p = 0.02), (9/10 vs. 0/10 vs. 3/10, respectively). Systolic aortic pressure, diastolic aortic pressure and coronary perfusion pressure were significantly higher with nifekalant during CPR and immediate post-resuscitation period (p < 0.05). The animals in the amiodarone group had a slower heart rate at the 1st and 45th min post-ROSC (p < 0.001 and p = 0.006, respectively). The number of electric shocks required for terminating VF, time to ROSC and adrenaline dose were significantly higher with amiodarone compared to nifekalant (p < 0.001). CONCLUSIONS: Nifekalant showed a more favorable hemodynamic profile and improved survival compared to amiodarone and saline in this swine model.
PURPOSE: The purpose of the experiment was to compare the effects of nifekalant and amiodarone on the return of spontaneous circulation (ROSC), survival, as well as on the hemodynamic parameters in a swine model of prolonged ventricular fibrillation (VF). METHODS: After 8 min of untreated VF, bolus doses of epinephrine (adrenaline) and either nifekalant, or amiodarone, or saline (n = 10 per group), were administered after randomization. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration and defibrillation was attempted 2 min later. CPR was resumed for another 2 min after each defibrillation attempt and the same dose of adrenaline was given every 4th minute during CPR. RESULTS: Forty-eight hour survival was significantly higher with nifekalant compared to amiodarone (p < 0.001) and saline (p = 0.02), (9/10 vs. 0/10 vs. 3/10, respectively). Systolic aortic pressure, diastolic aortic pressure and coronary perfusion pressure were significantly higher with nifekalant during CPR and immediate post-resuscitation period (p < 0.05). The animals in the amiodarone group had a slower heart rate at the 1st and 45th min post-ROSC (p < 0.001 and p = 0.006, respectively). The number of electric shocks required for terminating VF, time to ROSC and adrenaline dose were significantly higher with amiodarone compared to nifekalant (p < 0.001). CONCLUSIONS:Nifekalant showed a more favorable hemodynamic profile and improved survival compared to amiodarone and saline in this swine model.