Epinephrine and norepinephrine in cardiopulmonary resuscitation. Effects on myocardial oxygen delivery and consumption.


:Norepinephrine, an alpha 1,2-beta 1,2-adrenergic agonist, seems to be an alternative to epinephrine, an alpha 1,2-beta 1,2-agonist, for restoration of spontaneous circulation in VF. We therefore studied the effect of epinephrine and norepinephrine on MDO2 and MVO2 using OCCM after five minutes of cardiopulmonary arrest in 21 pigs. After OCCM of three minutes, seven animals each received placebo (controls) or epinephrine (45 micrograms/kg) or norepinephrine (45 micrograms/kg). All drugs were given blindly. At 90 seconds after epinephrine or norepinephrine, mean arterial blood pressure was significantly higher than in the control group. Prior to cardiac arrest, MBF, measured with radioactive microspheres, was 193 +/- 30 ml/min/100 g. During CPR but before drug administration, MBF was 51 +/- 23 in the control group, 71 +/- 10 in the group with epinephrine, and 74 +/- 11 ml/min/100 g in the group with norepinephrine. At 90 seconds after epinephrine, MBF increased to 126 +/- 18 and after norepinephrine to 107 +/- 30 ml/min/100 g (p less than 0.05). Compared to OCCM alone, MDO2 increased from 9.6 +/- 1.7 to 17.1 +/- 3.2 ml/min/100 g after epinephrine and from 9.4 +/- 1.8 to 13.6 +/- 4.2 ml/min/100 g after norepinephrine (p less than 0.05). There was an increase in MVO2 from 4.0 +/- 1.5 to 9.4 +/- 3.0 ml/min/100 g after epinephrine (p less than 0.05), whereas MVO2 increased only from 4.2 +/- 0.8 to 5.1 +/- 2.0 ml/min/100 g after norepinephrine. Because epinephrine led to a greater increase in MVO2 than norepinephrine, the myocardial oxygen ER remained unchanged. The oxygen requirements of the fibrillating heart seemed to be increased via beta 2-adrenergic stimulation. In both the control and epinephrine-treated groups, only three of the seven animals could be successfully resuscitated, whereas all of the animals in the group with norepinephrine survived the 15-minute period of observation. In this model, norepinephrine, in contrast to epinephrine, improves the balance between MDO2 and MVO2 and eases restoration of spontaneous circulation.






Lindner KH,Ahnefeld FW,Schuermann W,Bowdler IM




Has Abstract


1990-06-01 00:00:00
















  • Time course of hemosiderin production and clearance by human pulmonary macrophages.

    abstract::Tracheal aspirates from four previously healthy infants with acute pulmonary hemorrhage, and small volume bronchial lavages from children undergoing flexible fiberoptic bronchoscopy were examined for pulmonary alveolar macrophages (PAM) containing hemosiderin. Hemosiderin formation was also studied in vitro. Macrophag...


    pub_type: 杂志文章


    authors: Sherman JM,Winnie G,Thomassen MJ,Abdul-Karim FW,Boat TF

    更新日期:1984-09-01 00:00:00

  • Solnatide Demonstrates Profound Therapeutic Activity in a Rat Model of Pulmonary Edema Induced by Acute Hypobaric Hypoxia and Exercise.

    abstract:BACKGROUND:The synthetic peptide solnatide is a novel pharmacologic agent that reduces extravascular lung water, blunts reactive oxygen species production, and improves lung function due to its ability to directly activate the epithelial sodium channel. The goal of this study was to investigate the effect of solnatide ...


    pub_type: 杂志文章


    authors: Zhou Q,Wang D,Liu Y,Yang X,Lucas R,Fischer B

    更新日期:2017-03-01 00:00:00

  • Sleep apnea syndrome. A critical review of the apnea index as a diagnostic criterion.

    abstract::The utility of the apnea index (number of apneic events per hour of sleep) in diagnosing sleep apnea syndrome is reviewed. Data from currently extant reports indicate that many otherwise normal, aging subjects may be classified as having sleep apnea syndrome based on the current diagnostic threshold of five apneic epi...


    pub_type: 杂志文章


    authors: Berry DT,Webb WB,Block AJ

    更新日期:1984-10-01 00:00:00

  • Distinguishing left ventricular aneurysm from pseudoaneurysm. A review of the literature.

    abstract::A postmyocardial infarction left ventricular pseudoaneurysm occurs when a rupture of the ventricular free wall is contained by overlying, adherent pericardium. A postinfarction aneurysm, in contrast, is caused by scar formation resulting in thinning of the myocardium. Although the usual treatment for patients with pse...


    pub_type: 杂志文章,评审


    authors: Brown SL,Gropler RJ,Harris KM

    更新日期:1997-05-01 00:00:00

  • Intensive Monitoring of Urine Output Is Associated With Increased Detection of Acute Kidney Injury and Improved Outcomes.

    abstract:BACKGROUND:Urine output (UO) is a vital sign for critically ill patients, but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if the intensity of UO monitoring is ...


    pub_type: 杂志文章


    authors: Jin K,Murugan R,Sileanu FE,Foldes E,Priyanka P,Clermont G,Kellum JA

    更新日期:2017-11-01 00:00:00

  • Correlation of leukocyte esterase detection by reagent strips and the presence of neutrophils: a study in BAL fluid.

    abstract:STUDY OBJECTIVE:In the present study, we evaluated the leukocyte esterase (LE) area of a reagent strip designed for urinalysis for the semiquantitative measurement of the percentage of polymorphonuclear neutrophils (PMNs) in BAL fluid. DESIGN:Prospective. The relative PMN counts (obtained by conventional microscopy an...


    pub_type: 杂志文章


    authors: Jacobs JA,De Brauwer EI,Cornelissen EI,Drent M

    更新日期:2000-11-01 00:00:00

  • Poor symptom control is associated with reduced CT scan segmental airway lumen area in smokers with asthma.

    abstract:BACKGROUND:Cigarette smoking is associated with worse symptoms in asthma and abnormal segmental airways in healthy subjects. We tested the hypothesis that current symptom control in smokers with asthma is associated with altered segmental airway dimensions measured by CT scan. METHODS:In 93 subjects with mild, moderat...


    pub_type: 杂志文章


    authors: Thomson NC,Chaudhuri R,Spears M,Messow CM,MacNee W,Connell M,Murchison JT,Sproule M,McSharry C

    更新日期:2015-03-01 00:00:00

  • A combined modality approach to recurrent cardiac sarcoma resulting in a prolonged remission: a case report.

    abstract::We report a case of cardiac fibrosarcoma that was treated with cardiac tumor resection, chemotherapy, cardiac explantation, tumor repeat resection, and autotransplantation followed by external beam irradiation. The patient was able to achieve clinical remission and remained disease free > 2 years after the initial dia...


    pub_type: 杂志文章


    authors: Mery GM,Reardon MJ,Haas J,Lazar J,Hindenburg A

    更新日期:2003-05-01 00:00:00

  • Evaluation of right ventricular performance with a right ventricular ejection fraction thermodilution catheter and MRI in patients with pulmonary hypertension.

    abstract:STUDY OBJECTIVES:We sought to compare catheter studies using a right ventricular ejection fraction (REF) catheter together with echocardiography and MRI in patients with pulmonary hypertension. PATIENTS AND METHODS:We compared hemodynamic findings, echocardiography, and MRI studies in 16 patients with pulmonary hypert...


    pub_type: 杂志文章


    authors: Hoeper MM,Tongers J,Leppert A,Baus S,Maier R,Lotz J

    更新日期:2001-08-01 00:00:00

  • Clinical evaluation of pulmonary hypertension in systemic sclerosis and related disorders. A Doppler echocardiographic study of 135 Japanese patients.

    abstract:BACKGROUND:Previous studies on pulmonary hypertension (PH) in systemic sclerosis and related disorders used differing patient populations, and defined PH according to different criteria. We have attempted to determine the prevalence and cause of PH in these disorders using a mainly noninvasive cardiopulmonary evaluatio...


    pub_type: 杂志文章


    authors: Murata I,Takenaka K,Yoshinoya S,Kikuchi K,Kiuchi T,Tanigawa T,Ito K

    更新日期:1997-01-01 00:00:00

  • Proinflammatory cytokines and fibrinolytic enzymes in tuberculous and malignant pleural effusions.

    abstract:OBJECTIVES:To measure tumor necrosis factor-alpha (TNF-alpha) and interleukin-1beta (IL-1beta) in pleural effusions caused by tuberculosis (TB) and malignancy and their relationship with plasminogen activator inhibitor type I (PAI-1) and tissue type plasminogen activator (tPA), and to compare the differences between tu...


    pub_type: 杂志文章


    authors: Hua CC,Chang LC,Chen YC,Chang SC

    更新日期:1999-11-01 00:00:00

  • Renal and vascular effects of atrial natriuretic factor during cardiopulmonary bypass.

    abstract:STUDY OBJECTIVE:To evaluate renal and vasodilator effects of synthetic atrial natriuretic factor (ANF) in patients undergoing cardiopulmonary bypass (CPB) with special reference to the applicability of ANF as a diuretic and natriuretic. DESIGN:The study consisted of two parts. The first 15 consecutive patients in a un...


    pub_type: 临床试验,杂志文章


    authors: Hynynen M,Palojoki R,Heinonen J,Tikkanen I,Harjula AL,Fyhrquist F

    更新日期:1991-11-01 00:00:00

  • Depression is more common in girls with nonatopic asthma.

    abstract:BACKGROUND:Asthma may increase the risk of comorbid depressive disorders in children. Children suffering from asthma or depression are more often overweight. We examined whether depression was more likely in children with atopic and nonatopic asthma, independent of abdominal adiposity. METHODS:A cross-sectional analys...


    pub_type: 杂志文章


    authors: Bahreinian S,Ball GDC,Colman I,Becker AB,Kozyrskyj AL

    更新日期:2011-11-01 00:00:00

  • Is an abbreviated bronchial challenge with histamine valid?

    abstract::Investigators have validated an abbreviated protocol for testing nonspecific bronchial reactivity with methacholine. We performed a similar validation study with histamine, another bronchoprovocative agent known to induce airflow obstruction. Histamine is pharmacologically distinct from methacholine and, under some ci...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Schmidt LE,Thorne PS,Watt JL,Schwartz DA

    更新日期:1992-01-01 00:00:00

  • Smoking characteristics: differences in attitudes and dependence between healthy smokers and smokers with COPD.

    abstract:OBJECTIVE:To ascertain the differences in smoking characteristics between a group of smokers with COPD and another group of healthy smokers, both of which were identified in a population-based epidemiologic study. DESIGN AND PARTICIPANTS:This is an epidemiologic, multicenter, population-based study conducted in seven ...


    pub_type: 杂志文章,多中心研究


    authors: Jiménez-Ruiz CA,Masa F,Miravitlles M,Gabriel R,Viejo JL,Villasante C,Sobradillo V

    更新日期:2001-05-01 00:00:00

  • Genetics of COPD and emphysema.

    abstract::COPD is a highly prevalent disorder that results from the interplay of genetic susceptibility and environmental exposures. Over the past 2 decades, significant technological advances have been made in genetic investigations of complex diseases, yet limited progress has been made in the identification of additional COP...


    pub_type: 杂志文章,评审


    authors: Wan ES,Silverman EK

    更新日期:2009-09-01 00:00:00

  • Lung function abnormalities after bone marrow transplantation in children: has the trend recently changed?

    abstract:STUDY OBJECTIVES:To evaluate early and late lung function abnormalities and their predictors in a large sample of children who underwent bone marrow transplantation (BMT) for leukemias in the 1990s, highlighting changes with respect to the 1980s. DESIGNS:Prospective cohort. SETTING:A university department of pediatri...


    pub_type: 杂志文章


    authors: Cerveri I,Fulgoni P,Giorgiani G,Zoia MC,Beccaria M,Tinelli C,Locatelli F

    更新日期:2001-12-01 00:00:00

  • Diuretics in obstructive sleep apnea with diastolic heart failure.

    abstract:BACKGROUND:Upper airway edema might contribute to pharyngeal collapsibility and account for the high prevalence of obstructive sleep apnea (OSA) in patients with heart disease. The aim of this study was to evaluate if intensive unloading with diuretics improves sleep-disordered breathing and increases pharyngeal calibe...


    pub_type: 杂志文章


    authors: Bucca CB,Brussino L,Battisti A,Mutani R,Rolla G,Mangiardi L,Cicolin A

    更新日期:2007-08-01 00:00:00

  • The impact of new-onset atrial fibrillation on in-hospital mortality following cardiac surgery.

    abstract:BACKGROUND:The impact of new-onset postoperative atrial fibrillation (NAF) on in-hospital mortality (IHM) following cardiac surgery is unknown. METHODS:All patients without preoperative atrial fibrillation undergoing isolated coronary artery bypass graft surgery (CABG) and concomitant CABG and valve surgery were ident...


    pub_type: 杂志文章


    authors: Kalavrouziotis D,Buth KJ,Ali IS

    更新日期:2007-03-01 00:00:00

  • Efficacy and Safety of Pulmonary Arterial Hypertension-specific Therapy in Pulmonary Arterial Hypertension: A Meta-analysis of Randomized Controlled Trials.

    abstract:BACKGROUND:Previous meta-analyses of pulmonary arterial hypertension (PAH)-specific therapy for PAH pooled PAH-specific combination therapy and monotherapy. This flaw may threaten the authenticity of their findings. METHODS:PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials that ev...


    pub_type: 杂志文章,meta分析


    authors: Liu HL,Chen XY,Li JR,Su SW,Ding T,Shi CX,Jiang YF,Zhu ZN

    更新日期:2016-08-01 00:00:00

  • Frequency dependent phase and amplitude differences between simulated mouth and pleural pressures during panting. Demonstration with a mechanical model.

    abstract::A mechanical model was employed to examine phase and amplitude relationships between simulated pleural and mouth pressures during panting at different frequencies with and without lower airway obstruction and with rigid or flaccid extrathoracic airways. Results confirm the hypothesis that, in the presence of lower air...


    pub_type: 杂志文章


    authors: Knudson RJ,Knudson DE

    更新日期:1984-10-01 00:00:00

  • Chest wall echinococcosis.

    abstract::The chest wall is an uncommon localization for hydatid cyst. In this article, six patients were operated on because of chest wall hydatid cysts between the years 1989 to 1991 have been reported. Four of them had previously undergone surgery for pulmonary or hepatic hydatidosis; the chest wall was the primary site in t...


    pub_type: 杂志文章


    authors: Ozdemir N,Akal M,Kutlay H,Yavuzer S

    更新日期:1994-04-01 00:00:00

  • Treatment of a solitary pulmonary sarcoidosis mass by CT-guided direct intralesional injection of corticosteroid.

    abstract::A case is reported of 38-year-old woman with chest pain attributed to a left lung sarcoidosis mass. The mass failed to diminish and symptoms failed to resolve with systemic corticosteroid therapy. CT-guided direct intralesional transthoracic injection of dexamethasone resulted in resolution of the patient's symptoms a...


    pub_type: 杂志文章


    authors: Judson MA,Uflacker R

    更新日期:2001-07-01 00:00:00

  • Sleepiness and hypertension in obstructive sleep apnea.

    abstract::In order to assess the complications of sleep apnea, we have reviewed a data base of 619 consecutive admissions to a university sleep disorders center. Although patients with obstructive sleep apnea (OSA) described more subjective sleepiness than patients with central sleep apnea (CSA) or primary snoring (PS), the mul...


    pub_type: 杂志文章


    authors: Mendelson WB

    更新日期:1992-04-01 00:00:00

  • Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea: a 12-week, open-label study.

    abstract:STUDY OBJECTIVES:The purpose of this 12-week study was to evaluate the efficacy and safety of adjunct modafinil to treat excessive sleepiness in patients with obstructive sleep apnea (OSA) who experience residual sleepiness despite regular nasal continuous positive airway pressure (nCPAP) use. DESIGN:Twelve-week, open...


    pub_type: 临床试验,杂志文章,多中心研究


    authors: Schwartz JR,Hirshkowitz M,Erman MK,Schmidt-Nowara W

    更新日期:2003-12-01 00:00:00

  • Pasteurella multocida pneumonia in a man with AIDS and nontraumatic feline exposure.

    abstract::A case of acute pneumonia due to Pasteurella multocida ssp multocida occurred in a young man with AIDS and chronic sinusitis. The pneumonia was diagnosed by bronchoscopy and responded to treatment with aztreonam. Epidemiologic investigation revealed the case was temporally related to nontraumatic exposure to cat secre...


    pub_type: 杂志文章


    authors: Drabick JJ,Gasser RA Jr,Saunders NB,Hadfield TL,Rogers LC,Berg BW,Drabick CJ

    更新日期:1993-01-01 00:00:00

  • Catheter-induced tricuspid regurgitation. Incidence and clinical significance.

    abstract::The incidence and severity of catheter-induced tricuspid regurgitation has not been studied extensively. Given the frequency with which right heart catheters are employed to measure cardiac output, it is important to know whether the severity of catheter-induced tricuspid regurgitation is sufficient to invalidate the ...


    pub_type: 杂志文章


    authors: Stewart D,Leman RB,Kaiser J,Mann DL

    更新日期:1991-03-01 00:00:00

  • Clinical staging of patients with non-small cell lung cancer.

    abstract::This article is the first in a planned series from the Section on Lung Cancer of the ACCP addressing the important and clinically relevant aspects of what is now the most common malignancy in the world, lung cancer. This initial report addresses the problem of staging of lung cancer. Staging, or identifying the anatom...


    pub_type: 杂志文章


    authors: Little AG,Stitik FP

    更新日期:1990-06-01 00:00:00

  • Medical literature and vena cava filters: so far so weak.

    abstract:STUDY OBJECTIVE:With the development of percutaneous inferior vena cava (IVC) filters, IVC interruption has become a widely used procedure in patients with or at risk for venous thromboembolism. In an attempt at clarifying the indications for filter placement, a systematic literature review was undertaken. DESIGN:Bibl...


    pub_type: 杂志文章,评审


    authors: Girard P,Stern JB,Parent F

    更新日期:2002-09-01 00:00:00

  • Diagnosis of gastric aspiration by fiberoptic bronchoscopy.

    abstract::At the time of bronchoscopic observation, 28 of 31 patients proved to have aspirated gastric contents by the presence of gastric contents in the trachea or by direct observation of gastric aspiration followed by respiratory distress and erythema of subsegmental bronchi. Since gastric aspiration is a difficult diagnosi...


    pub_type: 杂志文章


    authors: Wolfe JE,Bone RC,Ruth WE

    更新日期:1976-10-01 00:00:00