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Journal of The Korean Society of Emergency Medicine 2023;34(6): 498-504. |
| Association between pralidoxime administration during cardiopulmonary resuscitation and brain tissue oxygen tension in a swine model of cardiac arrest |
Sang Won Ko1
, Young Il Min1,2
, Kyung Woon Jeung1,2
, Hyoung Youn Lee1,2
, Yong Hun Jung1,2
, Byung Kook Lee1,2
, Dong Hun Lee1
, Tag Heo1,2
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1Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
2Department of Emergency Medicine, Chonnam National University School of Medicine, Gwangju, Korea |
| Correspondence |
Young Il Min ,Tel: 062-220-6809, Fax: 062-228-7417, Email: minyi46@daum.net,
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Received: October 16, 2022; Revised: November 3, 2022 Accepted: November 3, 2022. Published online: December 31, 2023. |
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| ABSTRACT |
Objective:
Previous studies have suggested that epinephrine reduces brain tissue O2 tension (PbtO2) after the return of spontaneous circulation (ROSC) via α1-adrenoceptor stimulation and that pralidoxime had α1-adrenoceptor inhibitory action together with non-adrenergic vasopressor action. We sought to investigate the effects of pralidoxime administered during cardiopulmonary resuscitation (CPR) as a sole vasopressor on PbtO2 after ROSC. We hypothesized that pralidoxime administration would lead to a comparable ROSC rate and a higher PbtO2 after ROSC when compared to epinephrine administration.
Method:
After 7 minutes of ventricular fibrillation, 24 pigs randomly received either pralidoxime or epinephrine during CPR. Cerebral measurements, including PbtO2, were measured from the parietal cortices during the 60-minute postROSC period.
Results:
Coronary perfusion pressure (CPP) during CPR was significantly higher in the epinephrine group than in the pralidoxime group (P=0.012). All the animals in the epinephrine group achieved ROSC, while seven (58.3%) did so in the pralidoxime group (P=0.037). The area under the curves for PbtO2 during the post-ROSC period did not differ between the two groups.
Conclusion:
Pralidoxime alone was significantly inferior to epinephrine in increasing CPP and achieving ROSC. In addition, pralidoxime administration did not improve PbtO2 during the post-resuscitation period as compared with epinephrine. |
| Key words:
Pralidoxime; Epinephrine; Cardiopulmonary resuscitation |
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