Brown C G, Werman H A, Davis E A, Katz S, Hamlin R L
Ann Emerg Med. 1987 Jul;16(7):743-8. doi: 10.1016/s0196-0644(87)80566-8.
Prior studies have not found the alpha agonist phenylephrine, in a dose of 0.1 mg/kg, to be as effective as 0.20 mg/kg of epinephrine in improving regional cerebral blood flow (CBF) during CPR in swine. We undertook this study to assess whether higher doses of phenylephrine might improve regional CBF. Fifteen swine were allocated to receive either epinephrine 0.2 mg/kg, phenylephrine 1.0 mg/kg, or phenylephrine 10 mg/kg. Regional CBF measurements were made during normal sinus rhythm, during CPR, and during CPR following drug administration. Epinephrine 0.2 mg/kg was significantly better in improving regional CBF to the left and right cerebral cortices, cerebellum, midbrain, and cervical cord than was phenylephrine 1.0 mg/kg. There was no significant difference in regional CBF between the animals receiving epinephrine 0.2 mg/kg and phenylephrine 10 mg/kg. The study shows that large doses of epinephrine and phenylephrine may be required during CPR to improve regional cerebral blood flow following a prolonged arrest.
先前的研究并未发现剂量为0.1毫克/千克的α受体激动剂去氧肾上腺素在改善猪心肺复苏期间的局部脑血流量（CBF）方面与0.20毫克/千克的肾上腺素一样有效。我们进行这项研究以评估更高剂量的去氧肾上腺素是否能改善局部脑血流量。将15头猪分配为接受0.2毫克/千克肾上腺素、1.0毫克/千克去氧肾上腺素或10毫克/千克去氧肾上腺素。在正常窦性心律期间、心肺复苏期间以及给药后的心肺复苏期间进行局部脑血流量测量。0.2毫克/千克肾上腺素在改善左、右大脑皮层、小脑、中脑和颈髓的局部脑血流量方面明显优于1.0毫克/千克去氧肾上腺素。接受0.2毫克/千克肾上腺素和10毫克/千克去氧肾上腺素的动物之间局部脑血流量没有显著差异。该研究表明，在长时间心脏停搏后的心肺复苏期间，可能需要大剂量的肾上腺素和去氧肾上腺素来改善局部脑血流量。
