Atenolol in combination with epinephrine improves the initial outcome of cardiopulmonary resuscitation in a swine model of ventricular fibrillation
Rokas, Georgios I.
Papadimitriou, Lila J.
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Study Objectives: The aim of the present study was to assess whether a β-adrenergic blocking agent such as atenolol, administered during cardiopulmonary resuscitation, would improve initial resuscitation success. Methods: Ventricular fibrillation was induced in 20 Landrace/Large White piglets, which were left untreated for 8 minutes before attempted resuscitation with precordial compression, mechanical ventilation, and electrical defibrillation. Animals were randomized into 2 groups (10 animals each) to receive saline as placebo (20 mL dilution, bolus) + epinephrine (0.02 mg/kg) (group A) or atenolol (0.05 mg/kg per 20 mL dilution, bolus) + epinephrine (0.02 mg/kg) (group B) during cardiopulmonary resuscitation. Electrical defibrillation was attempted after 10 minutes of ventricular fibrillation. Results: Nine animals in group B restored spontaneous circulation in comparison to only 4 in group A. Aortic systolic and diastolic pressures as well as coronary perfusion pressure were significantly increased during cardiopulmonary resuscitation in group B. Furthermore, postresuscitation heart rate of the atenolol-treated group was significantly decreased. Conclusions: A β-adrenergic blocking agent, when administered during cardiopulmonary resuscitation, significantly improves initial resuscitation success and increases blood and coronary perfusion pressures during cardiopulmonary resuscitation.