Early adrenaline administration does not improve circulatory recovery during resuscitation from severe asphyxia in newborn piglets.
(2012) In Resuscitation 83(10). p.1298-1303- Abstract
- AIM OF THE STUDY: : To investigate the effects of early intravenous adrenaline administration on circulatory recovery, cerebral reoxygenation, and plasma catecholamine concentrations, after severe asphyxia-induced bradycardia and hypotension.
METHODS: One-day old piglets were left in apnoea until heart rate and mean arterial pressure were less than 50min(-1) and 25mmHg, respectively. They randomly received adrenaline, 10 μg kg(-1) (n=16) or placebo (n=15) and were resuscitated with air ventilation and, when needed, closed-chest cardiac massage (CCCM). Eight not asphyxiated animals served as time controls.
RESULTS: CCCM was required in 13 piglets given adrenaline and in 13 given placebo. Time to... (More) - AIM OF THE STUDY: : To investigate the effects of early intravenous adrenaline administration on circulatory recovery, cerebral reoxygenation, and plasma catecholamine concentrations, after severe asphyxia-induced bradycardia and hypotension.
METHODS: One-day old piglets were left in apnoea until heart rate and mean arterial pressure were less than 50min(-1) and 25mmHg, respectively. They randomly received adrenaline, 10 μg kg(-1) (n=16) or placebo (n=15) and were resuscitated with air ventilation and, when needed, closed-chest cardiac massage (CCCM). Eight not asphyxiated animals served as time controls.
RESULTS: CCCM was required in 13 piglets given adrenaline and in 13 given placebo. Time to return of spontaneous circulation was: 72 (66-85) s vs. 77 (64-178) s [median (quartile range)] (p=0.35). Time until cerebral regional oxygen saturation (CrS(O2)) had increased to 30% was 86 (79-152) s vs. 126 (88-309) s (p=0.30). The two groups did not differ significantly in CrS(O2), heart rate, arterial pressure, right common carotid artery blood flow, or number of survivors: 13 and 11 animals. Plasma concentration of adrenaline, 2.5min after resuming ventilation, was 498 (268-868) nmol l(-1)vs. 114 (80-306) nmol l(-1) (p=0.01). Corresponding noradrenaline concentrations were 1799 (1058-4182) nmol l(-1)vs. 1385 (696-3118) nmol l(-1) (ns). In the time controls, the concentrations were 0.4 (0.2-0.6) nmol l(-1) of adrenaline and 1.8 (1.3-2.4) nmol l(-1) of noradrenaline.
CONCLUSION: The high endogenous catecholamine levels, especially those of noradrenaline, may explain why early administered adrenaline did not significantly improve resuscitation outcome. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/2431488
- author
- Linnér, Rikard LU ; Werner, Olof LU ; Perez de Sá, Valéria LU and Cunha Goncalves, Doris LU
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Resuscitation
- volume
- 83
- issue
- 10
- pages
- 1298 - 1303
- publisher
- Elsevier
- external identifiers
-
- wos:000309050600034
- pmid:22445867
- scopus:84865865854
- pmid:22445867
- ISSN
- 1873-1570
- DOI
- 10.1016/j.resuscitation.2012.02.030
- language
- English
- LU publication?
- yes
- id
- a74ec3f7-4a5b-4fea-bf81-f72255098c0a (old id 2431488)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22445867?dopt=Abstract
- date added to LUP
- 2016-04-01 11:10:48
- date last changed
- 2022-02-10 17:23:05
@article{a74ec3f7-4a5b-4fea-bf81-f72255098c0a,
abstract = {{AIM OF THE STUDY: : To investigate the effects of early intravenous adrenaline administration on circulatory recovery, cerebral reoxygenation, and plasma catecholamine concentrations, after severe asphyxia-induced bradycardia and hypotension. <br/><br>
<br/><br>
METHODS: One-day old piglets were left in apnoea until heart rate and mean arterial pressure were less than 50min(-1) and 25mmHg, respectively. They randomly received adrenaline, 10 μg kg(-1) (n=16) or placebo (n=15) and were resuscitated with air ventilation and, when needed, closed-chest cardiac massage (CCCM). Eight not asphyxiated animals served as time controls. <br/><br>
<br/><br>
RESULTS: CCCM was required in 13 piglets given adrenaline and in 13 given placebo. Time to return of spontaneous circulation was: 72 (66-85) s vs. 77 (64-178) s [median (quartile range)] (p=0.35). Time until cerebral regional oxygen saturation (CrS(O2)) had increased to 30% was 86 (79-152) s vs. 126 (88-309) s (p=0.30). The two groups did not differ significantly in CrS(O2), heart rate, arterial pressure, right common carotid artery blood flow, or number of survivors: 13 and 11 animals. Plasma concentration of adrenaline, 2.5min after resuming ventilation, was 498 (268-868) nmol l(-1)vs. 114 (80-306) nmol l(-1) (p=0.01). Corresponding noradrenaline concentrations were 1799 (1058-4182) nmol l(-1)vs. 1385 (696-3118) nmol l(-1) (ns). In the time controls, the concentrations were 0.4 (0.2-0.6) nmol l(-1) of adrenaline and 1.8 (1.3-2.4) nmol l(-1) of noradrenaline. <br/><br>
<br/><br>
CONCLUSION: The high endogenous catecholamine levels, especially those of noradrenaline, may explain why early administered adrenaline did not significantly improve resuscitation outcome.}},
author = {{Linnér, Rikard and Werner, Olof and Perez de Sá, Valéria and Cunha Goncalves, Doris}},
issn = {{1873-1570}},
language = {{eng}},
number = {{10}},
pages = {{1298--1303}},
publisher = {{Elsevier}},
series = {{Resuscitation}},
title = {{Early adrenaline administration does not improve circulatory recovery during resuscitation from severe asphyxia in newborn piglets.}},
url = {{https://lup.lub.lu.se/search/files/2445615/3460018.pdf}},
doi = {{10.1016/j.resuscitation.2012.02.030}},
volume = {{83}},
year = {{2012}},
}