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The effect of CPR on plasma diltiazem concentrations in dogs
E V Capparelli1, H Zhao, J J Hanyok
1Department of Pharmacy, Hartford Hospital, Connecticut 06115.
Study Objective:
To determine the effect of cardiac arrest with CPR on diltiazem concentrations in dogs.
Design:
Prospective, double-blind, randomized trial.
Setting:
Laboratory at a large university-affiliated medical center.
Type Of Participants:
Twenty mongrel dogs.
Interventions:
Following administration of anesthesia, catheters were placed in the pulmonary artery, aortic arch, left ventricle, and right ventricle. Dogs were randomized to receive diltiazem (0.5 mg/kg) either 60 minutes before or during cardiac arrest with CPR. After 13 minutes of cardiac arrest, defibrillation was attempted.
Measurements And Main Results:
Frequent blood samples for diltiazem concentrations were obtained before, during, and after cardiac arrest. The mean diltiazem concentration rose 70% during CPR in the group that received diltiazem before cardiac arrest. The group that received diltiazem during CPR had concentrations five times greater than expected during sinus rhythm.
Conclusion:
Increased diltiazem concentrations are observed during CPR and are probably related to altered distribution encountered during CPR.