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Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest
Primary vasopressor efficacy of epinephrine during cardiopulmonary resuscitation (CPR) is due to its α-adrenergic effects. However, epinephrine plays β1-adrenergic actions, which increasing myocardial oxygen consumption may lead to refractory ventricular fibrillation (VF) and poor outcome. Effects o...
Autores principales: | , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138021/ https://www.ncbi.nlm.nih.gov/pubmed/34017043 http://dx.doi.org/10.1038/s41598-021-90202-w |
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author | Ruggeri, Laura Nespoli, Francesca Ristagno, Giuseppe Fumagalli, Francesca Boccardo, Antonio Olivari, Davide Affatato, Roberta Novelli, Deborah De Giorgio, Daria Romanelli, Pierpaolo Minoli, Lucia Cucino, Alberto Babini, Giovanni Staszewsky, Lidia Zani, Davide Pravettoni, Davide Belloli, Angelo Scanziani, Eugenio Latini, Roberto Magliocca, Aurora |
author_facet | Ruggeri, Laura Nespoli, Francesca Ristagno, Giuseppe Fumagalli, Francesca Boccardo, Antonio Olivari, Davide Affatato, Roberta Novelli, Deborah De Giorgio, Daria Romanelli, Pierpaolo Minoli, Lucia Cucino, Alberto Babini, Giovanni Staszewsky, Lidia Zani, Davide Pravettoni, Davide Belloli, Angelo Scanziani, Eugenio Latini, Roberto Magliocca, Aurora |
author_sort | Ruggeri, Laura |
collection | PubMed |
description | Primary vasopressor efficacy of epinephrine during cardiopulmonary resuscitation (CPR) is due to its α-adrenergic effects. However, epinephrine plays β1-adrenergic actions, which increasing myocardial oxygen consumption may lead to refractory ventricular fibrillation (VF) and poor outcome. Effects of a single dose of esmolol in addition to epinephrine during CPR were investigated in a porcine model of VF with an underlying acute myocardial infarction. VF was ischemically induced in 16 pigs and left untreated for 12 min. During CPR, animals were randomized to receive epinephrine (30 µg/kg) with either esmolol (0.5 mg/kg) or saline (control). Pigs were then observed up to 96 h. Coronary perfusion pressure increased during CPR in the esmolol group compared to control (47 ± 21 vs. 24 ± 10 mmHg at min 5, p < 0.05). In both groups, 7 animals were successfully resuscitated and 4 survived up to 96 h. No significant differences were observed between groups in the total number of defibrillations delivered prior to final resuscitation. Brain histology demonstrated reductions in cortical neuronal degeneration/necrosis (score 0.3 ± 0.5 vs. 1.3 ± 0.5, p < 0.05) and hippocampal microglial activation (6 ± 3 vs. 22 ± 4%, p < 0.01) in the esmolol group compared to control. Lower circulating levels of neuron specific enolase were measured in esmolol animals compared to controls (2[1–3] vs. 21[16–52] ng/mL, p < 0.01). In this preclinical model, β1-blockade during CPR did not facilitate VF termination but provided neuroprotection. |
format | Online Article Text |
id | pubmed-8138021 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-81380212021-05-25 Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest Ruggeri, Laura Nespoli, Francesca Ristagno, Giuseppe Fumagalli, Francesca Boccardo, Antonio Olivari, Davide Affatato, Roberta Novelli, Deborah De Giorgio, Daria Romanelli, Pierpaolo Minoli, Lucia Cucino, Alberto Babini, Giovanni Staszewsky, Lidia Zani, Davide Pravettoni, Davide Belloli, Angelo Scanziani, Eugenio Latini, Roberto Magliocca, Aurora Sci Rep Article Primary vasopressor efficacy of epinephrine during cardiopulmonary resuscitation (CPR) is due to its α-adrenergic effects. However, epinephrine plays β1-adrenergic actions, which increasing myocardial oxygen consumption may lead to refractory ventricular fibrillation (VF) and poor outcome. Effects of a single dose of esmolol in addition to epinephrine during CPR were investigated in a porcine model of VF with an underlying acute myocardial infarction. VF was ischemically induced in 16 pigs and left untreated for 12 min. During CPR, animals were randomized to receive epinephrine (30 µg/kg) with either esmolol (0.5 mg/kg) or saline (control). Pigs were then observed up to 96 h. Coronary perfusion pressure increased during CPR in the esmolol group compared to control (47 ± 21 vs. 24 ± 10 mmHg at min 5, p < 0.05). In both groups, 7 animals were successfully resuscitated and 4 survived up to 96 h. No significant differences were observed between groups in the total number of defibrillations delivered prior to final resuscitation. Brain histology demonstrated reductions in cortical neuronal degeneration/necrosis (score 0.3 ± 0.5 vs. 1.3 ± 0.5, p < 0.05) and hippocampal microglial activation (6 ± 3 vs. 22 ± 4%, p < 0.01) in the esmolol group compared to control. Lower circulating levels of neuron specific enolase were measured in esmolol animals compared to controls (2[1–3] vs. 21[16–52] ng/mL, p < 0.01). In this preclinical model, β1-blockade during CPR did not facilitate VF termination but provided neuroprotection. Nature Publishing Group UK 2021-05-20 /pmc/articles/PMC8138021/ /pubmed/34017043 http://dx.doi.org/10.1038/s41598-021-90202-w Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Ruggeri, Laura Nespoli, Francesca Ristagno, Giuseppe Fumagalli, Francesca Boccardo, Antonio Olivari, Davide Affatato, Roberta Novelli, Deborah De Giorgio, Daria Romanelli, Pierpaolo Minoli, Lucia Cucino, Alberto Babini, Giovanni Staszewsky, Lidia Zani, Davide Pravettoni, Davide Belloli, Angelo Scanziani, Eugenio Latini, Roberto Magliocca, Aurora Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
title | Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
title_full | Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
title_fullStr | Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
title_full_unstemmed | Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
title_short | Esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
title_sort | esmolol during cardiopulmonary resuscitation reduces neurological injury in a porcine model of cardiac arrest |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138021/ https://www.ncbi.nlm.nih.gov/pubmed/34017043 http://dx.doi.org/10.1038/s41598-021-90202-w |
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