Comparison of dopamine, dobutamine, and epinephrine in CPR

Two new catecholamines, dopamine and dobutamine, have found widespread use for cardiovascular support. The relative efficacy of these drugs in aiding resuscitation from cardiopulmonary arrest is unknown. Dogs were subjected to either asphyxial or fibrillatory cardiac arrest. Resuscitation was attempted with artificial ventilation, closed chest cardiac massage, and one of four iv drug protocols: dopamine, 40 mg; epinephrine, 1 mg; dobutamine, 50 mg; or no drug. The incidence of successful resuscitation from both asphyxial and fibrillatory arrest was significantly greater in groups receiving dopamine or epinephrine than in groups receiving dobutamine or no drug. There was no difference in success between the dopamine and epinephrine groups. The authors conclude that, in dogs, dopamine is a useful adjunct to CPR because of its alpha-adrenergic stimulating activity at high doses. Dobutamine does not appear to be of value as the initial therapy of cardiac arrest. If the response in man is similar to that in dogs, dopamine may provide an alternative to epinephrine during CPR.