[Are beta-sympathomimetic substances in resuscitation useful? Experimental studies]

Orciprenaline and epinephrine have been compared in cardiopulmonary resuscitation (CPR) in the dog. In a third group no substance was given. When orciprenaline was repeated without success, epinephrine was given. After administration of epinephrine left ventricular pressure and central aortic pressure were significantly higher. CPR was also more successful in epinephrine-treated dogs, a fact which can be attributed directly to these higher pressures. However, the attempt at resuscitation with orciprenaline, and, in the event of failure, with epinephrine, yielded significantly poorer results than treatment with epinephrine alone. Epinephrine substantially increased coronary perfusion pressure and coronary blood flow was adequate. When orciprenaline was administered, however, diastolic blood pressure decreased and no coronary blood flow could be measured. Serum CPK activity was increased. Ventricular fibrillation occurred just as often with epinephrine as with orciprenaline. In the epinephrine group defibrillation led directly to adequate circulation, whereas in the orciprenaline group subsequent electromechanical dissociation was observed. It is concluded that beta-receptor stimulators have no place in CPR. Epinephrine is the drug of choice in resuscitation after cardiac arrest.