Prengel A W, Lindner K H, Keller A
Department of Anesthesiology and Critical Care Medicine, University of Ulm, Germany.
Stroke. 1996 Jul;27(7):1241-8. doi: 10.1161/01.str.27.7.1241.
Administration of vasopressin during cardiopulmonary resuscitation (CPR) improves vital organ blood flow compared with epinephrine, but the effect of vasopressin on cerebral oxygenation and cerebral venous hypercarbia during CPR has not previously been studied.
Fourteen pigs were allocated to receive either epinephrine (0.2 mg/kg) or vasopressin (0.4 U/kg) after 4 minutes of ventricular fibrillation and 3 minutes of CPR. Cerebral blood flow was determined by radiolabeled microspheres, and arterial and cerebral venous blood gases were measured.
Cerebral blood flow, measured before and 90 seconds and 5 minutes after drug administration, was 9 (3; 12), 25 (19; 27), and 18 (10; 23) mL/min per 100 g (median and 25th and 75th percentiles, respectively) in the epinephrine group and 12 (5; 16), 51 (48; 70), and 53 (45; 63) mL/min per 100 g in the vasopressin group (P<.05 at 90 seconds, P<.01 at 5 minutes between groups). Five minutes after drug administration, cerebral venous Pco2 was 63 (59; 68) mm Hg in the epinephrine group and 47 (43; 55) mm Hg in the vasopressin group (P<.01); at the same time cerebral venous pH was 7.18 (7.17; 7.20) and 7.26 (7.22; 7.36) (P<.01) in the epinephrine and vasopressin groups, respectively. Cerebral oxygen extraction ratio, calculated before and 90 seconds and 5 minutes after drug administration, was 0.42 (0.32; 0.57), 0.47 (0.41; 0.57), and 0.56 (0.56; 0.64) in the epinephrine group and 0.43 (0.38; 0.45), 0.38 (0.25; 0.44), and 0.35 (0.33; 0.49) in the vasopressin group (P<.05 at 90 seconds and 5 minutes).
Compared with epinephrine, vasopressin not only increases cerebral blood flow but also improves cerebral oxygenation and decreases cerebral venous hypercarbia when administered during CPR in pigs.
与肾上腺素相比，在心肺复苏（CPR）期间给予血管加压素可改善重要器官的血流，但此前尚未研究血管加压素对CPR期间脑氧合及脑静脉高碳酸血症的影响。
14头猪在室颤4分钟及CPR 3分钟后，被分配接受肾上腺素（0.2mg/kg）或血管加压素（0.4U/kg）。通过放射性微球测定脑血流量，并测量动脉血和脑静脉血气。
肾上腺素组给药前、给药后90秒和5分钟时测得的脑血流量分别为每100g 9（3；12）、25（19；27）和18（10；23）mL/min（中位数及第25和第75百分位数），血管加压素组分别为每100g 12（5；16）、51（48；70）和53（45；63）mL/min（90秒时组间P<.05，5分钟时P<.01）。给药5分钟后，肾上腺素组脑静脉Pco2为63（59；68）mmHg，血管加压素组为47（43；55）mmHg（P<.01）；同时，肾上腺素组和血管加压素组脑静脉pH分别为7.18（7.17；7.20）和7.26（7.22；7.36）（P<.01）。给药前、给药后90秒和5分钟时计算得出的脑氧摄取率，肾上腺素组分别为0.42（0.32；0.57）、0.47（0.41；0.57）和0.56（0.56；0.64），血管加压素组分别为0.43（0.38；0.45）、0.38（0.25；0.44）和0.35（0.33；0.49）（90秒和5分钟时P<.05）。
与肾上腺素相比，在猪CPR期间给予血管加压素不仅可增加脑血流量，还可改善脑氧合并降低脑静脉高碳酸血症。
