Absence of myocardial protection with prostacyclin during cardiac arrest

Prostacyclin (PGI2) has been shown to present myocardial protective effects which could be beneficial during cardiac arrest. We tested this hypothesis in a closed-chest dog model in which electromechanical dissociation (EMD) can be predictably observed after 90 to 120 seconds of ventricular fibrillation without chest compression. Six dogs were pretreated with a PGI2 infusion at a rate of 1 mcg/kg/min and six other dogs served as control animals. After 60 seconds of ventricular fibrillation, EMD was already observed in 3 PGI2-treated dogs but in no control dog. After 90 seconds of ventricular fibrillation, EMD was present in 2 PGI2-treated dogs and in 2 control dogs, so that 4 control but only one PGI2-treated animal survived after 90 seconds of ventricular fibrillation. Ventricular defibrillation was also not facilitated in PGI2-treated dogs. The present study does not support PGI2 administration in cardiopulmonary resuscitation.