Brown C G, Birinyi F, Werman H A, Davis E A, Hamlin R L
Resuscitation. 1986 Nov;14(3):171-83. doi: 10.1016/0300-9572(86)90122-x.
Epinephrine in larger doses than currently recommended during cardiopulmonary resuscitation (CPR) has been shown to improve cerebral blood flow (CBF) following a 10-min arrest in a swine model. The purpose of this pilot study was to measure CBF during CPR, comparing high-dose epinephrine to a pure alpha-1 agonist, phenylephrine. Ten swine each weighing greater than 15 kg, were instrumented for regional CBF measurements using tracer microspheres. CBF was measured during normal sinus rhythm (NSR). Following 10 min of ventricular fibrillation, CPR was begun and regional CBF was again measured. Following 3 min of CPR, the swine were randomized to receive either epinephrine (0.2 mg/kg), or phenylephrine (0.1 mg/kg), through a peripheral intravenous line. Regional CBF was again measured 1 min after drug administration. Regional CBF following drug administration was compared using an analysis of covariance. Adjusted CBFs are expressed in ml/min per 100 g for epinephrine and phenylephrine, respectively: left cerebral cortex (12.5 vs. 2.3, P = 0.002); right cerebral cortex (13.0 vs. 2.8, P = 0.003); cerebellum (32.9 vs. 4.1, P = 0.004); midbrain (35.7 vs. 2.6, P = 0.0004), pons (30.3 vs. 2.9, P = O.006); medulla (49.5 vs. 13.6, P = 0.02) and cervical spinal cord (49.6 vs. 14.1, P = 0.003).
在猪模型中，心肺复苏（CPR）期间使用比目前推荐剂量更大的肾上腺素已被证明可在心脏停搏10分钟后改善脑血流量（CBF）。这项初步研究的目的是在CPR期间测量CBF，将高剂量肾上腺素与纯α-1激动剂去氧肾上腺素进行比较。十头体重超过15千克的猪，使用示踪微球进行区域CBF测量。在正常窦性心律（NSR）期间测量CBF。心室颤动10分钟后，开始CPR并再次测量区域CBF。CPR 3分钟后，猪被随机分配通过外周静脉管路接受肾上腺素（0.2毫克/千克）或去氧肾上腺素（0.1毫克/千克）。给药1分钟后再次测量区域CBF。使用协方差分析比较给药后的区域CBF。肾上腺素和去氧肾上腺素给药后的调整后CBF分别以每100克毫升/分钟表示：左大脑皮层（12.5对2.3，P = 0.002）；右大脑皮层（13.0对2.8，P = 0.003）；小脑（32.9对4.1，P = 0.004）；中脑（35.7对2.6，P = 0.0004），脑桥（30.3对2.9，P = 0.006）；延髓（49.5对13.6，P = 0.02）和颈脊髓（49.6对14.1，P = 0.003）。
