Lindner K H, Brinkmann A, Pfenninger E G, Lurie K G, Goertz A, Lindner I M
Department of Anesthesiology and Critical Care Medicine, University of Ulm, Germany.
Anesth Analg. 1993 Sep;77(3):427-35. doi: 10.1213/00000539-199309000-00003.
Based upon the hypothesis that vasopressin (antidiuretic hormone) may increase vascular resistance during ventricular fibrillation, the effects of this potent vasoconstrictor were studied in a porcine model of ventricular fibrillation. Vasopressin therapy was compared to epinephrine by randomly allocating 14 pigs to receive either 0.045 mg/kg of epinephrine (n = 7) or 0.8 U/kg of vasopressin (n = 7) after 4 min of ventricular fibrillation and 3 min of open-chest cardiopulmonary resuscitation. During cardiopulmonary resuscitation, myocardial blood flow before and 90 s and 5 min after drug administration was 57 +/- 11, 84 +/- 11, and 59 +/- 9 mL.min-1 x 100 g-1 (mean +/- SEM) in the epinephrine group, and 61 +/- 5, 148 +/- 26, and 122 +/- 22 mL.min-1 x 100 g-1 in the vasopressin group (P < 0.05 at 90 s and 5 min). At the same times, mean cardiac index was not significantly different between the groups. After drug administration, coronary venous PCO2 was significantly higher and coronary venous pH was significantly lower in the epinephrine as compared to the vasopressin group. All pigs in both groups were resuscitated and survived the 2-h observation period. We conclude that vasopressin improves vital organ perfusion during ventricular fibrillation and cardiopulmonary resuscitation. Vasopressin seems to be at least as effective as epinephrine in this pig model of ventricular fibrillation.
基于血管加压素（抗利尿激素）可能在心室颤动期间增加血管阻力这一假说，在猪心室颤动模型中研究了这种强效血管收缩剂的作用。通过将14头猪随机分配，使其在心室颤动4分钟和开胸心肺复苏3分钟后，分别接受0.045mg/kg肾上腺素（n = 7）或0.8U/kg血管加压素（n = 7），比较血管加压素治疗与肾上腺素治疗的效果。在心肺复苏期间，肾上腺素组给药前、给药后90秒和5分钟时的心肌血流量分别为57±11、84±11和59±9mL·min⁻¹×100g⁻¹（平均值±标准误），血管加压素组分别为61±5、148±26和122±22mL·min⁻¹×100g⁻¹（90秒和5分钟时P<0.05）。同时，两组间平均心脏指数无显著差异。给药后，与血管加压素组相比，肾上腺素组的冠状静脉PCO₂显著升高，冠状静脉pH显著降低。两组所有猪均成功复苏并存活至2小时观察期结束。我们得出结论，血管加压素可改善心室颤动和心肺复苏期间重要器官的灌注。在该猪心室颤动模型中，血管加压素似乎至少与肾上腺素一样有效。
