Dose-related response of centrally administered epinephrine on the change in aortic diastolic pressure during closed-chest massage in dogs.

The current recommendation of the American Heart Association is to give 0.5 to 1.0 mg (7.5 to 15 micrograms/kg in a 70-kg man) of epinephrine intravenously every five minutes during cardiac arrest. The optimal dose of epinephrine to augment the aortic diastolic pressure (ADP) is not known. The effect of various doses of central bolus epinephrine on the ADP during closed-chest massage was studied. A group of 25 large dogs was divided equally into five groups: control and 15, 45, 75, and 150 micrograms/kg. After three minutes of cardiac arrest, closed-chest massage was initiated, and the study drug was given two minutes later. The ADP and right atrial pressures were monitored for 15 minutes. Changes in ADP peaked at two minutes after injection in all groups receiving epinephrine, and the drop in ADP over time noted in the control group was prevented by increasing doses of epinephrine. Among the groups receiving epinephrine, however, there was no difference in the absolute ADP and diastolic coronary perfusion pressure.