Abstract
Objective: Although adrenaline administration is a part of the advanced life support algorithm, Its role has been questioned recently. Therefore, we conducted a study to investigate the effect of adrenaline administration on the haemodynamics during experimental cardiac arrest (CA).
Design: Randomized, unblinded, experimental study. Setting: Experimental laboratory in a university hospital.
Materials and methods: Ventricular fibrillation was induced for 15 minutes (two minutes without resuscitation attempts. three minutes of chest compressions. ten minutes of chest compressions and mechanical ventilation) in 14 anaesthetized domestic pias. After spontaneous circulation was restored, the animals were observed for 20 minutes.
Prior to CA induction, the experimental animals were randomized to receive a bolus of 15 mu g/kg of adrenaline intravenously (IV) in the 5th and 10th minute of CA (group A) or to undergo cardiopulmonary resuscitation without adrenaline administration (group B). Haemodynamic variables including coronary (CoPP) and cerebral perfusion pressure (CPP) were continuously monitored throughout the protocol.
Results: While return of spontaneous circulation was reached in all 7 group A animals. in group Bit was achieved in 5 animals only (p=0.462). The observed variables except body temperature were comparable in both the groups prior to the cardiac arrest induction.
Administration of adrenaline in group A resulted in a significant increase in CoPP in the first minute after both administrations compared to group B, where adrenaline was not administered (6th minute: 30.6 +/- 6.4 vs. 14.3 +/- 3.2 mm Hg, 11th minute: 29.4 +/- 8.5 vs. 12.3 +/- 2.4 mm Hg, p<0.05) with a gradual decrease to the baseline levels. A similar increase in CPP without undesirable elevation of the intracranial pressure was identified in group A.
Conclusion: In our experimental model of CA. regular adrenaline administration resulted in a significant temporary increase in CoPP and CPP without an unfavourable increase of the intracranial pressure.