Efficacy of terlipressin versus epinephrine in cardiopulmonary resuscitation in pigs: impact on the cerebral perfusion

• Grant number: 07/08741-9
• Support Opportunities: Regular Research Grants
• Start date: January 01, 2009
• End date: November 30, 2010
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Antonio Luis Eiras Falcão
• Grantee: Antonio Luis Eiras Falcão
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

The main objective of this study is to evaluate the effectiveness of terlipressin (TP) versus adrenaline (ADR) in the cardiopulmonary resuscitation (CPR) of pigs submitted to cardiac arrest (CA) in ventricular fibrillation (VF) and its implications on the cerebral perfusion. The cerebral perfusion pressure (PPC), oxygen tissue partial pressure (pTO2) and the intracranial pressure (PIC)will be evaluated. We expect to demonstrate that the terlipressin (TP) as vasopressor during the RCP can be more efficient than the adrenalin (ADR) keeping better levels of PPC and pTO2.Twenty four animals will be randomly assigned into three equal groups: 1) ADR, 2) TP and 3) TP + ADR. After the induction of VF, the animals will remain in non-assisted CA for 10 minutes. After this time, the American Heart Association (AHA) basic life support CPR (BLS-CPR) protocol will be applied for 2 minutes, and then the animals will receive by intravenous boluses: Group 1: ADR (45µg/kg); Group 2: TP (20µg/kg) and Group 3: TP (20µg/kg) + ADR (45µg/kg), and BLS-CPR will be maintained for additional 2 minutes. Then (at the 14th minute FV), external defibrillation attempts will be carried through with DC shocks, until the return of the spontaneous circulation or the release of 5 DC shocks, according to the AHA advanced cardiac life support (ACLS) CPR. The surviving animals will be observed for an additional 30 minutes period, thus being sacrificed. Continuous recordings of the electrocardiogram, systemic arterial blood pressure, intracranial pressure, oxygen tissue partial pressure, central venous pressure and end-tidal CO2 will be taken during the experiment. Arterial and central venous blood samples will be drawn for gas analysis at the following moments: before the induction of VF; at the end of the 10th min of unassisted VF; at the end of the 2nd min of BLS; just before de 1st DC shock and at the 10th min, 20th min and 30th min after CPR beginning in the surviving animals. (AU)