The effects of proximal and distal routes of intraosseous epinephrine administration on short-term resuscitative outcome measures in an adult swine model of ventricular fibrillation: a randomized controlled study - 14/12/15
, Arthur D. Johnson, PhD a, b, Jose Garcia-Blanco, MD b, Jacob Froehle, MSN a, Todd Morris, MSN a, Ben Althuisius, MSN a, Jennifer Richards, MSN a, Christopher Castano, MSN aAbstract |
Introduction |
It is unknown if the anatomical distance of intraosseous (IO) epinephrine injection from the heart affects resuscitative outcome. The purpose of this study was to explore the relationships between the anatomical distance of IO epinephrine injection and measures of resuscitative outcome in an adult swine model of ventricular fibrillation (VF).
Methods |
Thirty-two Yorkshire-cross swine (60–80 kg) were randomly assigned to four groups: humeral IO (HIO), tibial IO (TIO), IV with defibrillation and epinephrine, and IV control: with defibrillation but no epinephrine. Ventricular fibrillation was induced. Swine remained in VF for 4 minutes prior to mechanical chest compressions. After 6 minutes in VF, swine were defibrillated and epinephrine (0.01 mg/kg) administered by group assignment. Defibrillation was repeated every 2 minutes. Epinephrine was repeated every 4 minutes. Interventions continued until return of spontaneous circulation (ROSC) or 26 post-arrest minutes elapsed. Swine achieving ROSC were observed for 30 minutes post-ROSC.
Results |
There were no significant differences between the HIO, TIO, and IV groups relative to the occurrence of ROSC (P > .05 in all cases), 30-minute post-ROSC survival (P > .05 in all cases), and time to ROSC (P = .43). There were significant differences between the HIO, TIO, and IV groups compared to the control group relative to the occurrence of ROSC (P = .02, .01, and .007 respectively), and 30 minute post-ROSC survival (P = .05, .03, and .007, respectively).
Conclusion |
The anatomical distance of IO epinephrine injection from the heart did not affect short-term measures of resuscitative outcome in an adult swine model of VF including the occurrence of ROSC, 30 minute post-ROSC survival, and time to ROSC. Rapidly administered epinephrine, irrespective of route of administration, increased the chance ROSC and survival to 30 minutes post-ROSC would occur in this study.
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| ☆ | Conflict of interest statement: The authors declare there is no conflict of interest connected to this work. The views expressed in this work are those of the authors and do not reflect the official policy or views of the US Army, the US Department of Defense or the US Government. |
| ☆☆ | Funding Source: This work was funded by a postdoctoral fellowship (2014-F-13) granted by the American Association of Nurse Anesthetists Foundation. The funding source had no role in the design of the study; the collection, analysis, and interpretation of the data; writing the report; and the decision to submit the article for publication. |
| ★ | Presentations: This study was presented as a poster presentation at the Networking World Anesthesia Convention held in Vancouver, BC, Canada on 01 May 2015. Otherwise the manuscript, including related data, figures, and tables has not been published previously and is not under consideration for publication elsewhere. No writing assistance was used in the preparation of this manuscript. |
Vol 34 - N° 1
P. 49-53 - janvier 2016 Retour au numéro
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