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Kristian Wemmelund

Esmolol does not affect circulation negatively during resuscitation

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Background: Experimental studies have combined epinephrine with esmolol to attenuate post-ROSC myocardial dysfunction. Treatment with esmolol during cardiopulmonary resuscitation may be inappropriate due to esmolol's potential depressant effect on circulation. We aimed to compare the effects of epinephrine and esmolol, administered individually, on hemodynamic parameters using a placebo controlled, double blinded, porcine model of cardiac arrest.

Methods: Thirty pigs were randomized into three groups. After five minutes of untreated cardiac arrest, advanced life support (ALS) compressions and ventilation were initiated. Medication was administered at the beginning of the first, third, fifth, seventh and ninth ALS cycle. The epinephrine group received 20 mu g/kg epinephrine at every administration, the esmolol group received 0.5mg/kg esmolol at the first administration and isotonic saline subsequently, and the placebo group received isotonic saline. Defibrillation attempts were included from the fourth cycle and onwards. The primary endpoint was end-tidal carbon dioxide (ETCO2). Secondary endpoints included coronary perfusion pressure (CPP), mean arterial pressure (MAP) and return of spontaneous circulation (ROSC).

Results: The slopes between groups were significantly different over time for both ETCO2 (p

Conclusions: Esmolol either improved or showed no significant difference regarding all hemodynamic parameters compared to epinephrine and placebo. Our study does not disfavor the use of esmolol as a resuscitative drug. (C) 2018 Elsevier Inc. All rights reserved.

Original languageEnglish
JournalAmerican Journal of Emergency Medicine
Pages (from-to)690-695
Number of pages6
Publication statusPublished - Apr 2019

    Research areas

  • Cardiac arrest, Esmolol, Porcine model, Resuscitation

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