Intensive Care Medicine

, Volume 36, Issue 7, pp 1248–1255 | Cite as

Terlipressin versus adrenaline in an infant animal model of asphyxial cardiac arrest

  • Jesús López-Herce
  • Bárbara Fernández
  • Javier Urbano
  • Santiago Mencía
  • Maria J. Solana
  • Jimena del Castillo
  • Antonio Rodríguez-Núñez
  • Jose M. Bellón
Experimental

Abstract

Purpose

The objective of this study was to compare the efficacy of terlipressin versus adrenaline in an experimental infant animal model of asphyxial cardiac arrest (ACA).

Design

Prospective randomised animal study.

Setting

Laboratory research department of a university hospital.

Methods

Seventy-one, 2-month-old, mechanically ventilated piglets were investigated. ACA was induced by removal of mechanical ventilation. Resuscitation was performed by means of manual external chest compressions and mechanical ventilation (CC + V). After 3 min of CC + V, return of spontaneous circulation (ROSC) was observed in 11 animals. The 60 piglets without ROSC were then randomised to the four study groups: adrenaline standard dose (Asd): 0.01 mg/kg/3 min; adrenaline high dose (Ahd): first dose (0.01 mg/kg) and subsequent doses (0.1 mg/kg/3 min); terlipressin (T): 20 µg/kg/6 min; and adrenaline standard dose plus terlipressin (Asd + T).

Measurements and results

The relationship between haemodynamic (heart rate, blood pressure, ECG rhythm, cardiac index), respiratory (end-tidal CO2, blood gas analysis) and tissue perfusion (gastric intramucosal pH, central, cerebral and renal saturation) parameters and ROSC was analysed. ROSC was achieved in three piglets treated with Asd (20%), four treated with Ahd (26.7%), one treated with T (6.7%) and seven treated with Asd + T (46.7%) (P = 0.099). ROSC was achieved in 43.1% of animals with pulseless electrical activity, 30.4% with asystole and none with ventricular fibrillation (P = 0.0001).

Conclusion

In this infant animal model of cardiac arrest, there was a non-significant trend towards better outcome when terlipressin was combined with adrenaline compared with the use of adrenaline or terlipressin alone.

Keywords

Cardiac arrest Adrenaline Terlipressin Cardiopulmonary resuscitation Paediatrics 

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Copyright information

© Copyright jointly held by Springer and ESICM 2010

Authors and Affiliations

  • Jesús López-Herce
    • 1
  • Bárbara Fernández
    • 1
  • Javier Urbano
    • 1
  • Santiago Mencía
    • 1
  • Maria J. Solana
    • 1
  • Jimena del Castillo
    • 1
  • Antonio Rodríguez-Núñez
    • 2
  • Jose M. Bellón
    • 3
  1. 1.Pediatric Intensive Care ServiceHospital General Universitario Gregorio MarañónMadridSpain
  2. 2.Spanish Health Institute Carlos III, Maternal, Child Health and Development NetworkHospital Clínico Universitario de Santiago de CompostelaSantiago de Compostela Spain
  3. 3.Spanish Health Institute Carlos III, Maternal, Child Health and Development NetworkPreventive and Quality Control Service, Hospital General Universitario Gregorio Marañón MadridSpain

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