Effect of Epinephrine Administered during Cardiopulmonary Resuscitation on Cerebral Oxygenation after Restoration of Spontaneous Circulation in a Swine Model with a Clinically Relevant Duration of Untreated Cardiac Arrest

• Main Authors: Hyoung Youn Lee, Kamoljon Shamsiev, Najmiddin Mamadjonov, Yong Hun Jung, Kyung Woon Jeung, Jin Woong Kim, Tag Heo, Yong Il Min
• Format: Article
• Language: English
• Published: MDPI AG 2021-05-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: heart arrest; epinephrine; oxygen; hypoxia
• Online Access: https://www.mdpi.com/1660-4601/18/11/5896

Severe neurological impairment was more prevalent in cardiac arrest survivors who were administered epinephrine than in those administered placebo in a randomized clinical trial; short-term reduction of brain tissue O₂ tension (PbtO₂) after epinephrine administration in swine following a short duration of untreated cardiac arrest has also been reported. We investigated the effects of epinephrine administered during cardiopulmonary resuscitation (CPR) on cerebral oxygenation after restoration of spontaneous circulation (ROSC) in a swine model with a clinically relevant duration of untreated cardiac arrest. After 7 min of ventricular fibrillation, 24 pigs randomly received either epinephrine or saline placebo during CPR. Parietal cortex measurements during 60-min post-resuscitation period showed that the area under the curve (AUC) for PbtO₂ was smaller in the epinephrine group than in the placebo group during the initial 10-min period and subsequent 50-min period (both <i>p</i> < 0.05). The AUC for number of perfused cerebral capillaries was smaller in the epinephrine group during the initial 10-min period (<i>p</i> = 0.005), but not during the subsequent 50-min period. In conclusion, epinephrine administered during CPR reduced PbtO₂ for longer than 10 min following ROSC in a swine model with a clinically relevant duration of untreated cardiac arrest.