The Intrapulmonary Route for CPR Drugs

Abstract

In 1967 Redding et al demonstrated epinephrine responses in arrested dogs via the intra-tracheal route to be as prompt and effective as by the intravenous route (1). The 1974 NRC- AHA standards recommended this alternate route for epinephrine and lidocaine (2). This study of intrapulmonary (IP) uptake of three CPR drugs was performed on N₂O-hypoxic normocarbic dogs with interruption of the 5% O₂ mixture at the time of precipitous decompensation of the systolic blood pressure. External heart compression was needed in less than 50% of the experiments. This preparation provided an evaluation of the response onset times from alveolar instillation of the drug to the first change in the cardiac conduction mechanism. Results suggest that the intrapulmonary route for these CPR drugs is particularly advantageous if pulmonary blood flow is sufficient.