CORTICOSTEROID SUPPLEMENTATION DURING CARDIAC-ARREST IN RATS

Hypothesis: Corticosteroids will improve the rate of resuscitation fro m cardiac arrest. Design: Prospective blinded randomized placebo-contr olled trial. Intervention: An 8-min cardiac arrest was induced by KCl infusion and chest restriction in 36 male Sprague-Dawley rats with con tinuous EKG and arterial blood pressure monitoring. At the start of CP R the rats received one of three study drugs: normal saline (placebo), 0.05 mg hydrocortisone (Group A) and 0.25 mg hydrocortisone (Group B) . Mechanical ventilation, chest compressions and ACLS drug administrat ion were provided following a standardized algorithm. Results: The res uscitation rate was significantly higher (P < 0.05) in Group B (92%) c ompared to Group A (50%) and placebo (50%). For the rats resuscitated, the duration of CPR (placebo = 163 s, Group A = 126 s, Group B = 120 s) and the amount of epinephrine used (placebo = 0.007 mg, Group A = 0 .005 mg, Group B = 0.005 mg) did not reach statistical significance (P = 0.15 and P = 0.21). Conclusion: Hydrocortisone significantly increa sed the rate of ROSC from cardiac arrest. There also appears to be a t rend of decreasing duration of CPR and epinephrine requirements with h ydrocortisone. Further studies evaluating the mechanism of action and long term effects of hydrocortisone in cardiac arrest need to be condu cted.