Association between pralidoxime administration during cardiopulmonary resuscitation and brain tissue oxygen tension in a swine model of cardiac arrest
- Author:
Sang Won KO
1
;
Young Il MIN
;
Kyung Woon JEUNG
;
Hyoung Youn LEE
;
Yong Hun JUNG
;
Byung Kook LEE
;
Dong Hun LEE
;
Tag HEO
Author Information
1. Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea
- Publication Type:Original Article
- From:Journal of the Korean Society of Emergency Medicine
2023;34(6):498-504
- CountryRepublic of Korea
- Language:English
-
Abstract:
Objective:Previous studies have suggested that epinephrine reduces brain tissue O2 tension (PbtO2) after the return of spontaneous circulation (ROSC) via α1-adrenoceptor stimulation and that pralidoxime had α1-adrenoceptor inhibitory action together with non-adrenergic vasopressor action. We sought to investigate the effects of pralidoxime administered during cardiopulmonary resuscitation (CPR) as a sole vasopressor on PbtO2 after ROSC. We hypothesized that pralidoxime administration would lead to a comparable ROSC rate and a higher PbtO2 after ROSC when compared to epinephrine administration.
Methods:After 7 minutes of ventricular fibrillation, 24 pigs randomly received either pralidoxime or epinephrine during CPR. Cerebral measurements, including PbtO2, were measured from the parietal cortices during the 60-minute postROSC period.
Results:Coronary perfusion pressure (CPP) during CPR was significantly higher in the epinephrine group than in the pralidoxime group (P=0.012). All the animals in the epinephrine group achieved ROSC, while seven (58.3%) did so in the pralidoxime group (P=0.037). The area under the curves for PbtO2 during the post-ROSC period did not differ between the two groups.
Conclusion:Pralidoxime alone was significantly inferior to epinephrine in increasing CPP and achieving ROSC. In addition, pralidoxime administration did not improve PbtO2 during the post-resuscitation period as compared with epinephrine.
