The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model
Abstract Background Obtaining vascular access can be challenging during resuscitation following cardiac arrest, and it is particularly difficult and time-consuming in paediatric patients. We aimed to compare the efficacy of high-dose intramuscular (IM) versus intravascular (IV) epinephrine administr...
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| Format: | Article |
| Language: | English |
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BMC
2021-02-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-021-01917-7 |
| _version_ | 1818557905795809280 |
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| author | Daesung Lim Soo Hoon Lee Dong Hoon Kim Changwoo Kang Jin Hee Jeong Sang Bong Lee |
| author_facet | Daesung Lim Soo Hoon Lee Dong Hoon Kim Changwoo Kang Jin Hee Jeong Sang Bong Lee |
| author_sort | Daesung Lim |
| collection | DOAJ |
| description | Abstract Background Obtaining vascular access can be challenging during resuscitation following cardiac arrest, and it is particularly difficult and time-consuming in paediatric patients. We aimed to compare the efficacy of high-dose intramuscular (IM) versus intravascular (IV) epinephrine administration with regard to the return of spontaneous circulation (ROSC) in an asphyxia-induced cardiac arrest rat model. Methods Forty-five male Sprague-Dawley rats were used for these experiments. Cardiac arrest was induced by asphyxia, and defined as a decline in mean arterial pressure (MAP) to 20 mmHg. After asphyxia-induced cardiac arrest, the rats were randomly allocated into one of 3 groups (control saline group, IV epinephrine group, and IM epinephrine group). After 540 s of cardiac arrest, cardiopulmonary resuscitation was performed, and IV saline (0.01 cc/kg), IV (0.01 mg/kg, 1:100,000) epinephrine or IM (0.05 mg/kg, 1:100,000) epinephrine was administered. ROSC was defined as the achievement of an MAP above 40 mmHg for more than 1 minute. Rates of ROSC, haemodynamics, and arterial blood gas analysis were serially observed. Results The ROSC rate (61.5%) of the IM epinephrine group was less than that in the IV epinephrine group (100%) but was higher than that of the control saline group (15.4%) (log-rank test). There were no differences in MAP between the two groups, but HR in the IM epinephrine group (beta coefficient = 1.02) decreased to a lesser extent than that in the IV epinephrine group with time. Conclusions IM epinephrine induced better ROSC rates compared to the control saline group in asphyxia-induced cardiac arrest, but not compared to IV epinephrine. The IM route of epinephrine administration may be a promising option in an asphyxia-induced cardiac arrest. |
| first_indexed | 2024-12-14T00:05:49Z |
| format | Article |
| id | doaj.art-eaf0d92273f74614b53c4c61c9b2fe56 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-14T00:05:49Z |
| publishDate | 2021-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-eaf0d92273f74614b53c4c61c9b2fe562022-12-21T23:26:03ZengBMCBMC Cardiovascular Disorders1471-22612021-02-012111810.1186/s12872-021-01917-7The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat modelDaesung Lim0Soo Hoon Lee1Dong Hoon Kim2Changwoo Kang3Jin Hee Jeong4Sang Bong Lee5Department of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University HospitalDepartment of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University HospitalDepartment of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University HospitalDepartment of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University HospitalDepartment of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University HospitalDepartment of Emergency Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University HospitalAbstract Background Obtaining vascular access can be challenging during resuscitation following cardiac arrest, and it is particularly difficult and time-consuming in paediatric patients. We aimed to compare the efficacy of high-dose intramuscular (IM) versus intravascular (IV) epinephrine administration with regard to the return of spontaneous circulation (ROSC) in an asphyxia-induced cardiac arrest rat model. Methods Forty-five male Sprague-Dawley rats were used for these experiments. Cardiac arrest was induced by asphyxia, and defined as a decline in mean arterial pressure (MAP) to 20 mmHg. After asphyxia-induced cardiac arrest, the rats were randomly allocated into one of 3 groups (control saline group, IV epinephrine group, and IM epinephrine group). After 540 s of cardiac arrest, cardiopulmonary resuscitation was performed, and IV saline (0.01 cc/kg), IV (0.01 mg/kg, 1:100,000) epinephrine or IM (0.05 mg/kg, 1:100,000) epinephrine was administered. ROSC was defined as the achievement of an MAP above 40 mmHg for more than 1 minute. Rates of ROSC, haemodynamics, and arterial blood gas analysis were serially observed. Results The ROSC rate (61.5%) of the IM epinephrine group was less than that in the IV epinephrine group (100%) but was higher than that of the control saline group (15.4%) (log-rank test). There were no differences in MAP between the two groups, but HR in the IM epinephrine group (beta coefficient = 1.02) decreased to a lesser extent than that in the IV epinephrine group with time. Conclusions IM epinephrine induced better ROSC rates compared to the control saline group in asphyxia-induced cardiac arrest, but not compared to IV epinephrine. The IM route of epinephrine administration may be a promising option in an asphyxia-induced cardiac arrest.https://doi.org/10.1186/s12872-021-01917-7AsphyxiaCardiac arrestDrug administration routesEpinephrine |
| spellingShingle | Daesung Lim Soo Hoon Lee Dong Hoon Kim Changwoo Kang Jin Hee Jeong Sang Bong Lee The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model BMC Cardiovascular Disorders Asphyxia Cardiac arrest Drug administration routes Epinephrine |
| title | The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model |
| title_full | The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model |
| title_fullStr | The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model |
| title_full_unstemmed | The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model |
| title_short | The effect of high-dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia‐induced cardiac arrest rat model |
| title_sort | effect of high dose intramuscular epinephrine on the recovery of spontaneous circulation in an asphyxia induced cardiac arrest rat model |
| topic | Asphyxia Cardiac arrest Drug administration routes Epinephrine |
| url | https://doi.org/10.1186/s12872-021-01917-7 |
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