Severe neurological impairment was more prevalent in
cardiac arrest survivors who were administered
epinephrine than in those administered placebo in a randomized clinical trial; short-term reduction of brain tissue O2 tension (PbtO2) after
epinephrine administration in swine following a short duration of untreated
cardiac arrest has also been reported. We investigated the effects of
epinephrine administered during
cardiopulmonary resuscitation (
CPR) on cerebral oxygenation after restoration of spontaneous circulation (ROSC) in a swine model with a clinically relevant duration of untreated
cardiac arrest. After 7 min of
ventricular fibrillation, 24 pigs randomly received either
epinephrine or saline placebo during
CPR. Parietal cortex measurements during 60-min post-
resuscitation period showed that the area under the curve (AUC) for PbtO2 was smaller in the
epinephrine group than in the placebo group during the initial 10-min period and subsequent 50-min period (both p < 0.05). The AUC for number of perfused cerebral capillaries was smaller in the
epinephrine group during the initial 10-min period (p = 0.005), but not during the subsequent 50-min period. In conclusion,
epinephrine administered during
CPR reduced PbtO2 for longer than 10 min following ROSC in a swine model with a clinically relevant duration of untreated
cardiac arrest.