Epinephrine application via an endotracheal airway and via the Combitube in esophageal position

Crit Care Med. 2000 May;28(5):1445-9. doi: 10.1097/00003246-200005000-00031.

Abstract

Objective: To compare plasma concentrations and cardiovascular effects of epinephrine after application via a conventional endotracheal airway and via the esophageal lumen of a new emergency airway, the esophageal tracheal Combitube.

Design: Prospective, randomized study.

Setting: Center for Biomedical Research, University of Vienna.

Subjects: Fourteen juvenile swine received either an endotracheal tube (Group A) or a Combitube in esophageal position (Group B).

Interventions: In Part I of the study, epinephrine was administered during spontaneous beating of the heart; in Part II, epinephrine was administered during cardiopulmonary resuscitation, using a ten-fold higher dosage in Group B, respectively.

Measurements: Plasma epinephrine levels were measured 1, 2, 3, 5, 7, 10, 15, and 30 mins after application. Systolic arterial blood pressure and cardiac output in Part I, and end-tidal CO2 and coronary perfusion pressure in Part II were recorded.

Main results: In Part I, increased levels of plasma epinephrine and systolic arterial pressure were maintained significantly longer in Group B when compared with Group A. In Part II, no significant differences between the groups were found with regard to plasma epinephrine levels and hemodynamic variables.

Conclusion: Epinephrine applied via the esophageal lumen of the Combitube in a ten-fold higher dosage has similar effects on plasma epinephrine levels and hemodynamic variables compared to endotracheal administration.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Pressure / drug effects
  • Cardiopulmonary Resuscitation
  • Dose-Response Relationship, Drug
  • Epinephrine / administration & dosage*
  • Epinephrine / blood
  • Esophagus*
  • Female
  • Intubation / instrumentation*
  • Intubation, Intratracheal / instrumentation*
  • Male
  • Swine

Substances

  • Epinephrine