Wenzel V, Linder K H, Augenstein S, Prengel A W, Strohmenger H U
Department of Anesthesiology, University of Ulm, Germany.
Stroke. 1998 Jul;29(7):1462-7; discussion 1467-8. doi: 10.1161/01.str.29.7.1462.
It is unknown whether a combination of vasopressin and epinephrine may be superior to vasopressin alone by targeting both nonadrenergic and adrenergic receptors.
After 15 minutes of cardiac arrest (13 minutes of ventricular fibrillation and 2 minutes of pulseless electrical activity) and 3 minutes of chest compressions, 16 animals were randomly treated with either 0.8 U/kg vasopressin (n = 8) or 0.8 U/kg vasopressin combined with 200 microg/kg epinephrine (n = 8).
Comparison of vasopressin with vasopressin and epinephrine at 90 seconds and 5 minutes after drug administration resulted in comparable mean (+/-SEM) coronary perfusion pressure (54+/-3 versus 57+/-5 and 36+/-4 versus 35+/-4 mm Hg, respectively), cerebral perfusion pressure (59+/-6 versus 65+/-8 and 40+/-6 versus 39+/-6 mm Hg, respectively), and median (25th to 75th percentiles) left ventricular myocardial blood flow [116 (81 to 143) versus 108 (97 to 125) and 44 (35 to 81) versus 62 (42 to 74) mL x min(-1) x 100 g(-1), respectively], but significantly increased (P<0.05) total cerebral blood flow [81 (77 to 95) versus 39 (34 to 58) and 50 (43 to 52) versus 28 (16 to 35) mL x min(-1) x 100 g(-1), respectively]. Return of spontaneous circulation rates in both groups were comparable (vasopressin, 7 of 8; vasopressin and epinephrine, 6 of 8).
Comparison of vasopressin with vasopressin and epinephrine resulted in comparable left ventricular myocardial blood flow but significantly increased cerebral perfusion.
血管加压素和肾上腺素联合使用通过作用于非肾上腺素能和肾上腺素能受体，是否优于单独使用血管加压素尚不清楚。
在心脏骤停15分钟（室颤13分钟和无脉电活动2分钟）及胸外按压3分钟后，16只动物被随机分为两组，分别接受0.8 U/kg血管加压素治疗（n = 8）或0.8 U/kg血管加压素联合200 μg/kg肾上腺素治疗（n = 8）。
给药后90秒和5分钟时，比较血管加压素组与血管加压素联合肾上腺素组，平均（±标准误）冠状动脉灌注压（分别为54±3与57±5以及36±4与35±4 mmHg）、脑灌注压（分别为59±6与65±8以及40±6与39±6 mmHg）和左心室心肌血流量中位数（第25至75百分位数）[分别为116（81至143）与108（97至125）以及44（35至81）与62（42至74）mL·min⁻¹·100 g⁻¹]相当，但总脑血流量显著增加（P<0.05）[分别为81（77至95）与39（34至58）以及50（43至52）与28（16至35）mL·min⁻¹·100 g⁻¹]。两组自主循环恢复率相当（血管加压素组8只中有7只；血管加压素联合肾上腺素组8只中有6只）。
血管加压素与血管加压素联合肾上腺素比较，左心室心肌血流量相当，但脑灌注显著增加。
