[Is calcium indicated in resuscitation? Experimental studies in dogs]

This study compares the effect of epinephrine (11 dogs) with that of the combination of epinephrine with calcium (10 dogs) in CPR after anoxial cardiac arrest. In the epinephrine group resuscitation was successful in all 11 dogs within 4 minutes. In the calcium group only 7 out of 10 dogs could be resuscitated: 3 dogs died during CPR in cause of irreversible fibrillation (2 cases) and "stone heart" (1 case). High CPK-activity reflected severe myocardial cell damage. In the survivors of the calcium group cardiac function was significantly impaired: 1. decreased left ventricular pressure (LVP) and contractility (dp/dt max), 2. increased afterload, 3. decreased cardiac output inspite of increased heart rate, 4. as a consequence, reduced perfusion of the vital organs. - These results foster the conclusion that calcium should not be used henceforth in CPR. Epinephrine was and is still the drug of choice in resuscitation after cardiac arrest.