The effects of endothelin-1 on coronary perfusion pressure during cardiopulmonary resuscitation in a canine model

D. J. DeBehnke, D. Spreng, L. L. Wickman, D. T. Crowe

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Abstract

Objective: To study the hemodynamic effects of exogenously administered endothelin-1 (ET-1), a peptide produced by endothelial cells with potent non-adrenergically mediated vasoconstrictor properties. Methods: A prospective drug intervention study was carried out in a resuscitation research laboratory. Fifteen mixed-breed dogs were anesthetized aud instrumented for hemodynamic monitoring. Asphyxia arrest was produced by clamping the endotracheal tube. Hemodynamic data were collected continuously. Following loss of aortic fluctuations monitored by thoracic aortic catheter, the animals remained in pulseless electrical activity (PEA) for 10 minutes. After 10 minutes of no-flow PEA, closed-chest CPR was begun and the animals were randomized to one of three treatment groups (EPI, 0.02 mg/kg epinephrine IV every 3 minutes; ENDO, 100 μg ET-I IV at 0 minutes; and EPI/ENDO, a combination of the EPI and ENDO treatments). Results: ENDO and EPI alone produced similar coronary perfusion pressures (CPPs). The EPI/ENDO combination produced significantly improved CPP compared with that of either EPI or ENDO alone. In the EPI group, the best mean CPP was 16 ± 14 mm Hg and occurred 7 minutes after drug administration. In the ENDO group, the best mean CPP was 28 ± 7 mm Hg and occurred 13 minutes after drug administration. In the EPI/ENDO combination group, the best mean CPP was 61 ± 37 mm Hg and occurred 7 minutes after drug administration (p < 0.05 compared with the EPI and ENDO groups alone). Conclusion: ET-1 is a potent vasoconstrictor. The combination of EPI and ENDO significantly improved CPP compared with that for either agent alone. ET-1 should be investigated further as a vasoconstrictor in cardiac arrest.

Original languageEnglish (US)
Pages (from-to)137-141
Number of pages5
JournalAcademic Emergency Medicine
Volume3
Issue number2
DOIs
StatePublished - Jan 1 1996

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Keywords

  • CPR
  • asphyxia
  • cardiac arrest
  • coronary perfusion pressure
  • endothelin
  • resuscitation

ASJC Scopus subject areas

  • Emergency Medicine

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