Plasma catecholamine concentrations after successful resuscitation in patients

Crit Care Med. 1992 May;20(5):609-14. doi: 10.1097/00003246-199205000-00011.

Abstract

Objectives: To measure plasma catecholamine concentrations after cardiopulmonary resuscitation (CPR) and to correlate catecholamine concentrations with heart rate (HR), BP, and plasma glucose and lactate concentrations.

Design: Prospective, descriptive study.

Setting: Emergency medical service at a University Hospital.

Patients: Ten patients (58 to 85 yrs) with out-of-hospital cardiac arrest.

Interventions: At 1, 5, 15, 30, and 60 mins after restoration of spontaneous circulation, blood samples were drawn and BP and HR were measured. Plasma catecholamine concentrations were measured by high-pressure liquid chromatography and plasma glucose and lactate concentrations were measured by enzymatic methods.

Main results: Median plasma epinephrine and norepinephrine concentrations were 136.3 micrograms/L (136,300 pg/mL), range 27.6 to 397.6 micrograms/L (27,600 to 397,600 pg/mL), and 4.7 micrograms/L (4700 pg/mL), range 1.8 to 14.5 micrograms/L (1800 to 14,500 pg/mL), respectively, at 1 min. Median plasma epinephrine and norepinephrine concentrations decreased to 8.7 micrograms/L (8700 pg/mL), range 1.2 to 55.0 micrograms/L (1200 to 55,000 pg/mL) and 1.9 micrograms/L (1900 pg/mL), range 1.3 to 5.8 micrograms/L (1300 to 5800 pg/mL), respectively, at 60 mins after restoration of spontaneous circulation. Epinephrine concentrations decayed with a semilogarithmic decay pattern. The half-life for the alpha phase was 2.2 mins and was 38.7 mins for the beta phase. Mean values of systolic arterial pressure were between 136 +/- 23 mm Hg at 1 min and 120 +/- 15 mm Hg at 30 mins. Median plasma glucose concentrations were between 8.2 mmol/L (147.7 mg/dL; range 5.8 to 11.2 mmol/L [104.5 to 201.8 mg/dL]) at 1 min and 13.9 mmol/L (250.4 mg/dL; range 9.7 to 16.6 mmol/L [174.8 to 299.1 mg/dL]) at 30 mins. Lactate values were between 11.4 mmol/L (range 4.7 to 16.5) at 1 min and 5.2 mmol/L (range 2.7 to 12.5) at 60 mins. No significant correlations were found between circulating catecholamine concentrations and the other variables.

Conclusions: After CPR, plasma catecholamine concentrations remained at high values but they did not lead to increases in BP, HR, or circulating glucose concentrations.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • Cardiopulmonary Resuscitation / standards*
  • Dopamine / administration & dosage
  • Dopamine / blood
  • Dopamine / therapeutic use
  • Emergency Service, Hospital
  • Epinephrine / blood*
  • Epinephrine / pharmacokinetics
  • Female
  • Heart Arrest / blood*
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy
  • Hemodynamics
  • Hospitals, University
  • Humans
  • Lactates / blood
  • Male
  • Middle Aged
  • Norepinephrine / blood*
  • Norepinephrine / pharmacokinetics
  • Prospective Studies
  • Time Factors

Substances

  • Blood Glucose
  • Lactates
  • Dopamine
  • Norepinephrine
  • Epinephrine