Co-administration of vasopressin-levosimendan improves survival in a swine model of ventricular fibrillation
Pantazopoulos, Ioannis N.
Papadimitriou, Lila J.
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OBJECTIVE It was hypothesized that the co-administration of vasopressin and levosimendan during cardiopulmonary resuscitation would improve survival and neurological outcome in comparison to the administration of vasopressin alone, in a swine model of ventricular fibrillation. METHOD Ventricular fibrillation was induced in 30 piglets. The animals were randomized into two groups, to receive either vasopressin and placebo (group A, n=15) or vasopressin and levosimendan (group B, n=15). The animals were left untreated for 8 minutes before attempted resuscitation was conducted according to the 2005 international guidelines. RESULTS During cardiopulmonary resuscitation, coronary perfusion pressure increased significantly in group B. The mean level of serum lactate was statistically significantly decreased in group B 2 hours after return of spontaneous circulation. The levels of NSE and S-100 protein were significantly increased in group A, 2 and 4 hours into the post-resuscitation phase. Spontaneous circulation was restored in 6 animals in group A and in all 15 in group B (p<0.05). Four animals in group A survived the 48-hour observational period in comparison to 14 animals in group B (p<0.05). The neurological outcome was better in group B than in group A. CONCLUSIONS The co-administration of vasopressin-levosimendan during cardiopulmonary resuscitation increases the likelihood of return of spontaneous circulation, results in better 48-hour survival and improves the neurological outcome, in comparison to the administration of vasopressin alone, in a swine model of ventricular fibrillation.