Administration of glucagon and epinephrine during cardiopulmonary resuscitation improves hemodynamics and survival in a swine model of prolonged ventricular fibrillation

Abstract

coronary perfusion pressure (CPP) calculated. CBF was continuously monitored by a transonic flow probe. VF was electrically induced andPEAproducedbydelivering electrical countershock(s). CPR, including mechanical chest compression and ventilation, was then initiated and continued for 15min. Epi (20 g/kg) was administered into the right atrium after 2min of CPR and repeated every 3min thereafter. If animals were resuscitated, the study sequence was repeated after 30min of recovery. Results: A total of 19 experimental cycles were completed with a mean of 2±1 cycles/pig. CPP significantly increased from 14±6mmHg before epi to a peak of 32±13mmHg (p<0.01) at 1min after epi administration. Concurrent with CPP increases, CBF decreased from 46±19mL/min before epi to the lowest value of 22±18mL/min (p<0.01) at 30 s after epi (Fig. 1). Both increase in CPP and decrease in CBF persisted beyond 3min after epi. However, while CPP already decreased to 24±12mmHg, CBF persisted with a low flow of 25±12mL/min 3min after epi. Conclusions: In this model, administration of epi significantly increased CPP during CPR. Increases in CPP, however, were not accompanied by increases in CBF, which was markedly reduced following epi.