Abstract 140: Early Administration of Epinephrine Improves Good Neurological Outcome at 24 Hours in a Porcine Model of Prolonged, Untreated Ventricular Fibrillation
Background: The utility of epinephrine during resuscitation efforts for out-of-hospital cardiac arrest is increasingly questioned. But most clinical reports have administered epinephrine late in the resuscitation effort, typically 10-15 minutes after arrival of EMS personnel. The advent of emergent intraosseous access has made rapid administration of ACLS drugs possible. We hypothesized that early administration of epinephrine would improve survival with good neurological function among those suffering VF cardiac arrest, but receiving no bystander CPR.
Methods: Sixty-three domestic swine (25±5 kg) had VF electrically induced and left untreated for 10 minutes. Animals received epinephrine at three different time intervals; 1, 4 or 8 minutes after the onset of chest compressions. Defibrillation was attempted 1 to 2 minutes after epinephrine administration. ACLS resuscitation efforts continued until ROSC or 25 minutes total. A swine cerebral performance category (CPC) was determined at 24 hours after onset of cardiac arrest.
Results: Fifty-nine (94%) animals were successfully resuscitated with no differences among the 3 administration times. Forty-six animals survived 24 hours with 40 having favorable neurological function (CPC1+2). Both, 24-hour survival and favorable neurological function were significantly improved after 1 min epinephrine administration compared with the later administration times (p<0.05).
Conclusion: Following 10 minutes of untreated VF, early administration of epinephrine results in improved favorable 24-hour neurological outcome in this clinically realistic swine model of out-of hospital cardiac arrest.
- © 2012 by American Heart Association, Inc.