Department of Experimental Surgery and Surgical Research, University of Athens, Medical School, 11 527 Athens, Greece.
Resuscitation. 2012 Apr;83(4):527-32. doi: 10.1016/j.resuscitation.2011.09.015. Epub 2011 Oct 1.
To study the effects of the combination of adrenaline (epinephrine) and vasopressin compared to adrenaline alone on initial resuscitation success, 24h survival, and neurological outcome in a swine model of asphyxial cardiac arrest (CA).
This prospective randomized experimental study was conducted at a laboratory research department. Twenty female Landrace/Large-White pigs, 12-15 weeks of age, were investigated. Asphyxial CA was induced by clamping of the endotracheal tube. After 4min of untreated CA, resuscitation was initiated by unclamping the endotracheal tube, mechanical ventilation, chest compressions and adrenaline (Group A) or a combination of adrenaline with vasopressin (Group A+V) administered intravenously. In case of restoration of spontaneous circulation (ROSC), the animals were monitored for 30min and then observed for 24h.
Hemodynamic variables were measured at baseline during CPR and in the post-resuscitation period. Statistically significant difference was observed in groups A and A+V regarding coronary perfusion pressure (CPP) during the first minute of CPR. In both groups, ROSC and survival rates were comparable (p=NS). Neurological deficit score (NDS) was significantly higher in the combination group 24h following CA (p<0.001). Brain histological damage score (HDS) was also better in the combination group (p<0.001). Total HDS and NDS showed a statistical significant correlation (p<0.001).
In this porcine model of asphyxial CA, adrenaline alone as well as the combined administration of adrenaline and vasopressin resulted in similar ROSC and survival rates, but the combination of adrenaline and vasopressin resulted in improved neurological and cerebral histopathological outcomes.
研究肾上腺素（epinephrine）与血管加压素联合应用与单独使用肾上腺素对窒息性心脏骤停（CA）猪模型初始复苏成功、24 小时存活率和神经结局的影响。
这是一项在实验室研究部门进行的前瞻性随机实验研究。共纳入 20 头 12-15 周龄的长白-大约克母猪。通过夹闭气管内导管诱发窒息性 CA。在未经治疗的 CA 持续 4 分钟后，通过松开气管内导管、机械通气、胸外按压和静脉内给予肾上腺素（A 组）或肾上腺素与血管加压素联合（A+V 组）来开始复苏。一旦恢复自主循环（ROSC），动物将被监测 30 分钟，然后观察 24 小时。
在 CPR 期间和复苏后测量血流动力学变量。在 CPR 的第一分钟，A 组和 A+V 组的冠状动脉灌注压（CPP）存在统计学显著差异。在这两组中，ROSC 和存活率相当（p=NS）。CA 后 24 小时，联合组的神经缺损评分（NDS）明显更高（p<0.001）。联合组的脑组织损伤评分（HDS）也更好（p<0.001）。总 HDS 和 NDS 呈统计学显著相关（p<0.001）。
在这种窒息性 CA 的猪模型中，单独使用肾上腺素和联合使用肾上腺素和血管加压素均导致相似的 ROSC 和存活率，但肾上腺素和血管加压素联合使用可改善神经和脑组织病理学结果。
