Hoffmann A C, Scheidegger D
Département d'Anesthésie, Hôpital Cantonal Universitaire, Bâle.
Ann Fr Anesth Reanim. 1990;9(3):204-7. doi: 10.1016/S0750-7658(05)80171-6.
Among the adrenergic receptor agonists, epinephrine, at alpha and beta stimulating doses, remains the drug of choice for cardiopulmonary resuscitation. However, alpha adrenergic agonists such as phenylephrine, methoxamine and dopamine (at alpha stimulating doses) result in similar success rates of resuscitation as epinephrine. In the opposite, beta adrenergic agonists, without or with only low alpha stimulating effect, such as isoproterenol or dobutamine are significantly less efficient. There are few data indicating that sodium bicarbonate improves outcome. Moreover it carries the risk of adverse effects. It may be of benefit in case of preexisting metabolic acidosis or during prolonged resuscitation with documented acidosis. Calcium remains indicated in case of hypocalcaemia, hyperkalaemia or calcium channel blocker intoxication. Severe ionized hypocalcaemia can occur after out-of-hospital cardiac arrest.
在肾上腺素能受体激动剂中，肾上腺素在给予α和β刺激剂量时，仍然是心肺复苏的首选药物。然而，α肾上腺素能激动剂，如去氧肾上腺素、甲氧明和多巴胺（给予α刺激剂量时），其复苏成功率与肾上腺素相似。相反，β肾上腺素能激动剂，无论有无或仅有低α刺激作用，如异丙肾上腺素或多巴酚丁胺，其效率显著较低。几乎没有数据表明碳酸氢钠能改善预后。此外，它还存在不良反应的风险。在存在预先存在的代谢性酸中毒或长时间复苏且有记录的酸中毒时，它可能有益。在低钙血症、高钾血症或钙通道阻滞剂中毒的情况下，仍然需要使用钙剂。院外心脏骤停后可能会发生严重的离子化低钙血症。
