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Post-resuscitation plasma catecholamines after prolonged arrest in a swine model
James T Niemann1, Daniel Garner
1Department of Emergency Medicine, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 21, Torrance, CA 90509, USA. jniemann@emedharbor.edu
Resuscitation
|March 31, 2005
Summary
Post-resuscitation hemodynamics show decreased cardiac function and increased systemic vascular resistance. This adrenergic state, driven by low blood pressure, may worsen cardiac function after successful resuscitation.
Area of Science:
- Cardiovascular Physiology
- Critical Care Medicine
- Resuscitation Science
Background:
- Plasma catecholamine surges are known after cardiac arrest and CPR.
- The temporal profile of catecholamines post-resuscitation and their hemodynamic impact are less understood.
Purpose of the Study:
- To measure plasma catecholamines after successful resuscitation.
- To investigate the relationship between post-resuscitation catecholamines and hemodynamic parameters.
Main Methods:
- Ventricular fibrillation cardiac arrest was induced in swine.
- Conventional cardiopulmonary resuscitation (CPR) and defibrillation were performed.
- Hemodynamic variables and plasma catecholamines were measured after restoration of spontaneous circulation (ROSC).
Main Results:
- Cardiac function (contractility, stroke volume, stroke work) and mean arterial pressure (MAP) significantly decreased post-ROSC.
- Systemic vascular resistance (SVR) significantly increased post-ROSC.
- Elevated SVR and MAP correlated negatively with plasma epinephrine and norepinephrine levels.
Conclusions:
- A post-resuscitation adrenergic state is characterized by decreased MAP and increased SVR.
- This adrenergic response, while potentially compensatory, may contribute to impaired cardiac function after resuscitation.