Adenosine during cardiac arrest and cardiopulmonary resuscitation: a placebo-controlled, randomized trial

Crit Care Med. 1992 May;20(5):645-9. doi: 10.1097/00003246-199205000-00017.

Abstract

BACKGROUND AND HYPOTHESIS TESTED: The effects of adenosine (100 micrograms/kg/min; n = 7) were examined during rodent cardiopulmonary resuscitation (CPR). Change in coronary artery perfusion pressure, end-tidal PCO2, and arterial acid-base status of anesthetized, male, Sprague-Dawley rats were compared with CPR controls (0.9% sodium chloride; n = 7) and with sham controls (n = 9). Sustained ventricular fibrillation was induced and precordial chest compression was followed by defibrillation.

Results: After 6 mins of cardiac arrest, six (86%) of seven adenosine-treated animals were resuscitated after adenosine infusion and four (57%) of seven control animals were resuscitated after sodium chloride infusion. During chest compression, coronary artery perfusion pressure was 7 +/- 2 mm Hg after adenosine, but was 22 +/- 3 mm Hg in the controls (p less than .01). Parallel decreases were observed in mean aortic pressure. Arterial and end-tidal PCO2 significantly (p less than .01) decreased after adenosine. These changes contrasted with a second control group of nine identically prepared animals which, in the absence of ventricular fibrillation and subsequent chest compression, demonstrated no changes in hemodynamic, respiratory, or blood gas variables.

Conclusions: Adenosine decreased coronary artery perfusion pressure. However, despite marked reductions in coronary artery perfusion pressure, survival was not compromised after adenosine infusion in this rodent model of CPR.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acid-Base Equilibrium / drug effects
  • Adenosine / administration & dosage
  • Adenosine / pharmacology*
  • Adenosine / therapeutic use
  • Animals
  • Blood Gas Analysis
  • Cardiopulmonary Resuscitation / standards*
  • Coronary Circulation / drug effects
  • Disease Models, Animal
  • Heart Arrest / drug therapy*
  • Heart Arrest / mortality
  • Heart Arrest / physiopathology
  • Hemodynamics / drug effects
  • Infusions, Intravenous
  • Male
  • Rats
  • Rats, Inbred Strains
  • Survival Rate
  • Tidal Volume / drug effects

Substances

  • Adenosine