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Journal of The Korean Society of Emergency Medicine 1994;5(2): 168-175. |
| THE EFFECTIVENESS OF HIGH-DOSE EPINEPHRINE PRETREATMENT ON PROLONGED VENTRICULAR FIBRILLATION IN A SWINE MODEL |
| Ho Shik Shim, Ok Kyoung Choi |
| Department of Emergency Medicine, Severance Hospital, YUMC |
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Published online: December 31, 1994. |
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| ABSTRACT |
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There is a continual loss of high-energy phosphates in myocardium during prolonged ventricular fibrillation(VF), which cannot support myocardial contraction after defibrillation. Defibrillation should be attempted regardless of the duration of VF but the cumulative energy imparted to the fibrillating myocardium can induce structural myocardial injury. The myocardial blood flow requirements during VF are 50ml/min/100g, one third of blood flow, during nor mal sinus rhythm in swine. To attain this level of myocardial blood flow, epinephrine is required during CPR.
The purpose of this study was to determine the effectiveness of epinephrine preceding defibrillation in a swine model of prolonged VF and comparing these results to initial defibrillation treatment only. Fourteen swine (20-25kg) were anesthezied and instrumented for hemodynamic monitoring. After eight minutes of VF, the control group(7) received defibrillation at 3J/kg. If unsuccessful, two additional defibrillation were attempted at 6J/kg. (AHA guideline) The other animals(7, experimental group) were given 0.025mg/kg epinephrine after eight minutes of VF. After two minutes of epinephrine injection, defibrillation was attempted in the same manner as the control group. If unsuccessful, the same dose of epinephrine was administered and external cardiac massage was begun. The mean weight of both group was 21 土1kg. Systemic blood pressure was 110 土 15/68 土12mmHg, 114 土 22/78 土 22mmHg in
the control group, experimental group, respectively. There were no statistical differences in blood pressure and pulse rate between two groups. In the control group, 14 % of the animals were resuscitated to a perfusing rhythm. In the experimental group, 71% of the animals were resuscitated to a perfusing rhythm. These results suggest that method of epinephrine pretreatment preceding defibrillation is more effective for restoration of spontaneous circulation than that of initial defibrillation in 8 minutes prolonged ventricular fibrillation in a swine model. |
| Key words:
Prolonged Ventricular Fibrillation, Epinephrine, Defibrillation |
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