Supplement of levosimendan to epinephrine improves initial resuscitation outcomes from asphyxial cardiac arrest.

Abstract

BACKGROUND:

Levosimendan exerted favorable effects on the initial outcome in the treatment of ventricular fibrillation cardiac arrest. This study investigated the efficacy of levosimendan in the treatment of asphyxia-induced cardiac arrest in rats.

METHODS:

Animals underwent asphyxial cardiac arrest/cardiopulmonary resuscitation, randomized to three treatment groups: epinephrine (10 μg/kg) supplemented with levosimendan (bolus 12 μg/kg and infusion for 1 h, EL group); epinephrine only (10 μg/kg, E group), or levosimendan only (bolus 12 μg/kg and infusion for 1 h, L group). The resuscitation success rate, wet-to-dry ratio of lung, and rate of alveolar and blood gas analysis were recorded.

RESULTS:

10 rats in the EL group, 8 in the E group, and 2 in the L group showed an initial return of spontaneous circulation (P < 0.001); among them, 10, 4, and 2 rats survived at the end of a 60-min observation period from each group, respectively (P = 0.001). The coronary perfusion pressure in the EL group was higher than that of either the E or L group (P < 0.05). The lung wet-to-dry weight ratio and rate of damaged alveoli were lower in the EL group than the E group (P < 0.05).

CONCLUSIONS:

In the early stage of resuscitation for asphyxia-induced cardiac arrest in rats, levosimendan supplemented with epinephrine can significantly increase coronary perfusion pressure, reduce lung injury, and ultimately enhance the survival rate.

• Authors: Bingjing Wu, Yong G Peng, Shishi Zhao, Nana Bao, Linmin Pan, Jiaojiao Dong, Xuzhong Xu, Quanguang Wang
• Journal: BMC anesthesiology (BMC Anesthesiol) Vol. 17 Issue 1 Pg. 18 (Feb 02 2017) ISSN: 1471-2253 [Electronic] England
• PMID: 28148233 (Publication Type: Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Bronchodilator Agents
• Hydrazones
• Pyridazines
• Simendan
• Epinephrine

Topics

• Acute Lung Injury (pathology, prevention & control)
• Animals
• Anti-Arrhythmia Agents (administration & dosage)
• Asphyxia (etiology, therapy)
• Bronchodilator Agents (administration & dosage)
• Coronary Circulation (drug effects)
• Drug Therapy, Combination
• Epinephrine (administration & dosage)
• Heart Arrest, Induced
• Hydrazones (administration & dosage)
• Lung (pathology)
• Pyridazines (administration & dosage)
• Rats, Sprague-Dawley
• Resuscitation (methods)
• Simendan