Vasopressin improves survival in a pig model of hypothermic cardiopulmonary resuscitation

Crit Care Med. 2002 Jun;30(6):1311-4. doi: 10.1097/00003246-200206000-00027.

Abstract

Objective: During hypothermic cardiopulmonary resuscitation with a body core temperature <30 degrees C administration of a vasopressor to support coronary perfusion pressure is controversial. The purpose of the current study was to assess the effects of a single 0.4-unit/kg dose of vasopressin on coronary perfusion pressure, defibrillation success, and 1-hr survival in a pig model of hypothermic closed-chest cardiopulmonary resuscitation combined with rewarming.

Design: Prospective, randomized study in an established pig model.

Setting: University hospital research laboratory.

Subjects: Fifteen 12- to 16-wk-old domestic pigs.

Interventions: Pigs were surface cooled to a body core temperature of 26 degrees C and ventricular fibrillation was induced. After 15 mins of untreated cardiac arrest, manual closed-chest cardiopulmonary resuscitation and thoracic lavage with 40 degrees C warmed tap water were started. After 3 mins of external chest compression, animals were assigned randomly to receive vasopressin (0.4 units/kg, n = 8; or saline placebo, n = 7). Defibrillation was attempted 10 mins after drug administration.

Measurements and main results: Compared with saline placebo treated-animals, coronary perfusion pressure in vasopressin-treated pigs was significantly higher 90 secs (36 +/- 5 mm Hg vs. 7 +/- 4 mm Hg, p =.000) to 10 mins (24 +/- 4 mm Hg vs. 8 +/- 4 mm Hg, p =.000) after drug administration. Restoration of spontaneous circulation and 1 hr survival were significantly higher in vasopressin animals compared with saline placebo (8 of 8 vasopressin pigs vs. 0 of 7 placebo pigs, p <.001).

Conclusions: A single 0.4-unit/kg dose of vasopressin administered at a body core temperature <30 degrees C significantly improved defibrillation success and 1-hr survival in a pig model of hypothermic cardiopulmonary resuscitation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cardiopulmonary Resuscitation / methods*
  • Hypothermia / drug therapy*
  • Hypothermia / therapy
  • Lactates / blood
  • Rewarming
  • Swine
  • Treatment Outcome
  • Vasoconstrictor Agents / therapeutic use*
  • Vasopressins / therapeutic use*

Substances

  • Lactates
  • Vasoconstrictor Agents
  • Vasopressins