ENDOBRONCHIAL VASOPRESSIN IMPROVES SURVIVAL DURING CARDIOPULMONARY-RESUSCITATION IN PIGS

Background: Intravenous administration of vasopressin during cardiopul monary resuscitation (CPR) has been shown to be more effective than op timal doses of epinephrine, This study evaluated the effect of endobro nchial vasopressin during CPR. Methods: After 4 min of untreated ventr icular fibrillation and 3 min of CPR, 21 pigs were randomized to be tr eated with 0.8 U/kg intravenous vasopressin (n = 7), 0.8 U/kg endobron chial vasopressin (n = 9), or an endobronchial :placebo of normal sali ne (n = 5). Defibrillation was performed 5 min after drug administrati on to attempt return of spontaneous circulation. Results: All animals in the intravenous and endobronchial vasopressin group were resuscitat ed successfully, but only two of five animals in the placebo group wer e. At 2 and 5 min after drug administration, coronary perfusion pressu re in the intravenous and endobronchial vasopressin group was signific antly higher than in the placebo group (50 +/- 10, 34 +/- 5 vs. 16 +/- 6 mmHg, respectively; and 35 +/- 10, 39 +/- 10 vs. 19 +/- 5 mmHg, res pectively; P < 0.05). Conclusions: Endobronchial vasopressin is absorb ed during CPR, coronary perfusion pressure is increased significantly within a short period, and the chance of successful resuscitation is i ncreased in this porcine model of CPR, Endobronchial vasopressin may b e an alternative for vasopressor administration during CPR, when intra venous access is delayed or not available.