RESUSCITATION FROM CARDIAC-ARREST IN CATS - INFLUENCE OF EPINEPHRINE DOSAGE ON BRAIN RECOVERY

The quality of brain recovery after cardiac arrest depends crucially o n the speed of cardiac resuscitation because the low cerebral perfusio n pressure during the resuscitation procedure facilitates the developm ent of no-reflow. To accelerate return of spontaneous circulation, hig h dose epinephrine has been recommended but the effect on the dynamics of early brain recovery is still unknown. We, therefore, studied the dynamics of brain resuscitation after cardiopulmonary resuscitation (C PR) with standard and high dose epinephrine using non-invasive NMR tec hniques. Fifteen min cardiac arrest was induced in normothermic cats b y ventricular fibrillation. CPR was performed using an inflatable pneu matic vest for cyclic chest compression. With the beginning of CPR the standard dose group received 0.02 mg/kg epinephrine (n = 6) and the h igh dose group received 0.2 mg/kg (n = 8). Brain recovery was monitore d by magnetic resonance imaging of the apparent diffusion coefficient (ADC) of water for 3 h. Although high dose epinephrine treatment led t o a significantly higher blood pressure during early reperfusion, rapi dly changing heterogeneities of early brain recovery were observed in both groups. High dose epinephrine thus does not improve the quality o f post-cardiac arrest brain recovery during the first 3 h of reperfusi on.