SPLANCHNIC AND RENAL BLOOD-FLOW AFTER CARDIOPULMONARY-RESUSCITATION WITH EPINEPHRINE AND VASOPRESSIN IN PIGS

In laboratory investigations, vasopressin given during CPR resulted in improved vital organ blood flow when compared with epinephrine. Given the profound and long lasting vasopressor effects of vasopressin, we tested the hypothesis that vasopressin given during CPR would result i n renal and splanchnic hypoperfusion in the post-resuscitation period when compared with epinephrine. After 4 min of ventricular fibrillatio n, 16 pigs were randomly assigned to receive either 0.045 mg.kg(-1) ep inephrine or 0.4 U.kg(-1) vasopressin before defibrillation. Splanchni c and renal blood flow were measured 30, 90, and 240 min after restora tion of spontaneous circulation (ROSC) in the epinephrine and vasopres sin groups and in a control group of eight pigs using radiolabeled mic rospheres. Hepatic blood flow was measured before arrest and 30, 90, a nd 240 min after ROSC by means of indocyanine green infusion. Thirty m inutes after ROSC, renal and adrenal blood flow were significantly low er in the vasopressin group (300 [273-334] and 256 [170-284] ml.min(-1 ).100 g(-1)) (median and 25th and 75th percentile) as compared with th e epinephrine group (370 [346-429] and 360 [326-420] ml.min(-1).100 g( -1); P < 0.05). Pancreatic, intestinal, and hepatic blood flow were no t significantly different in animals after receiving epinephrine or va sopressin. In comparison to epinephrine, vasopressin given during card iac arrest impairs renal and adrenal perfusion temporarily but does no t lead to intestinal or hepatic hypoperfusion in the post-resuscitatio n phase. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.