Milrinone Combined with Vasopressin Improves Cardiac Index After Cardiopulmonary Resuscitation in a Pig Model of Myocardial Infarction.
From: Department of Anesthesiology, University Hospital Erlangen, Germany. palmaers@kfa.imed.uni-erlangen.de
Anesthesiology
- Publish Date: Jan 2007
- ISSN: 0003-3022
- Volume: 106
- Issue: 1
- Pages: 100-6
- Medium: Print
- Language: English
- Citation (JAMA): Palmaers Thomas, Albrecht Sven, Heuser Fabian, et al. Milrinone Combined with Vasopressin Improves Cardiac Index After Cardiopulmonary Resuscitation in a Pig Model of Myocardial Infarction.. Anesthesiology Jan 2007;106:100-6
Abstract
BACKGROUND: Milrinone used for acute cardiac insufficiency could be of interest during cardiopulmonary resuscitation because of its positive inotropic effects. In this study, the combination of milrinone-vasopressin was compared with epinephrine and vasopressin, as well as with the combination of epinephrine-vasopressin, in reference to hemodynamics. METHODS: Thirty-two pigs underwent ligation of the circumflex coronary artery and induction of ventricular fibrillation lasting for 4 min. Cardiopulmonary resuscitation was performed after randomization to one of four groups: epinephrine (30-microg/kg bolus), vasopressin (0.4-U/kg bolus), epinephrine-vasopressin (15-microg/kg epinephrine bolus, 0.2-U/kg vasopressin bolus), or milrinone-vasopressin (0.4-U/kg vasopressin bolus, 50-microg/kg milrinone bolus over 5 min and a continuous infusion of 0.4 microg.kg.min). The hemodynamic variables were measured before cardiopulmonary resuscitation as well as 4, 8, 15, and 30 min after return of spontaneous circulation. RESULTS: All animals were resuscitated successfully. The animals of the milrinone-vasopressin group displayed significantly (P<0.05) higher cardiac index values (30 min after return of spontaneous circulation: epinephrine, 65.8+/-13.2; vasopressin, 70.7+/-18.3; epinephrine-vasopressin, 69.1+/-36.2; milrinone-vasopressin, 120.7+/-34.8 ml.min.kg) without a decrease in mean arterial pressure or coronary perfusion pressure. CONCLUSIONS: The combination of vasopressin-milrinone as compared with epinephrine during cardiopulmonary resuscitation leads to an improved cardiac index without relevant decrease of mean arterial pressure or coronary perfusion pressure.
Mesh Headings (Keywords): Animals, Blood Pressure, Cardiopulmonary Resuscitation, Coronary Circulation, Disease Models, Animal, Drug Therapy, Combination, Male, Milrinone, Myocardial Infarction, Phosphodiesterase Inhibitors, Swine, Vasopressins
Check for Full Text / PubMed Unique Identifier (PMID): 17197851
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