The Impact of Dopamine on Hemodynamics, Oxygen Metabolism, and Cerebral Resuscitation After Restoration of Spontaneous Circulation in Pigs

• Published in: The Journal of emergency medicine Vol. 40; no. 3; pp. 348 - 354
• Main Authors: Liu, Zhaoxia, MM, Li, Chunsheng, MM, Wu, Junyuan, MM, Wu, Caijun, MM, Zhang, Guichen, MM
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2011
• Subjects: Animal models; Animals; Aorta; Blood pressure; Cardiac arrest; cardiopulmonary resuscitation; Cardiopulmonary Resuscitation - methods; Cerebrovascular Circulation - drug effects; Cerebrovascular Circulation - physiology; Disease Models, Animal; Dopamine; Dopamine - pharmacology; Electrical stimuli; Emergency; Fibrillation; Heart; Heart Arrest - mortality; Heart Arrest - therapy; Hemodynamics; Hemodynamics - drug effects; Hemodynamics - physiology; Intravenous administration; Male; Metabolism; Nervous system; Oxygen consumption; Oxygen Consumption - drug effects; Oxygen Consumption - physiology; Oxygen Inhalation Therapy - methods; Perfusion; Random Allocation; restoration of spontaneous circulation; Survival Analysis; Swine; Ventricular Fibrillation - diagnosis; Ventricular Fibrillation - therapy; cardiopulmonary resuscitation; restoration of spontaneous circulation; hemodynamics; Cardiac arrest
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2009.08.049

Abstract Background: Restoration of spontaneous circulation after cardiopulmonary resuscitation in cardiac arrest patients does not always signal a completely successful outcome. Functional deficiencies of the nervous system are found in many survivors of cardiac arrest. Objectives: To study the effects of dopamine-induced elevated blood pressure on the hemodynamics, oxygen metabolism, and cerebral resuscitation in different perfusion conditions in a resuscitated animal model. Methods: There were 18 pigs included in the study. Ventricular fibrillation (VF) was induced with a programmed electrical stimulation device. After 4 min of untreated ventricular fibrillation followed by 9 min of CPR, 12 animals were resuscitated successfully, and were then randomly assigned to either the study group (dopamine group) or the control group (normal perfusion group). All animals in the two groups received normal saline through continuous intravenous guttae for 4 h at a rate of 15 mL/kg/h. In the study group, dopamine was added to raise the animals' blood pressure. Four hours of intensive monitoring was performed for all study animals. Finally, 24-h evaluation of neurological function was conducted in surviving animals in accordance with the standard of the Cerebral Performance Category Score. Results: In animals in the dopamine group, the cardiac output, mean aortic pressure, coronary perfusion pressure, oxygen delivery, and oxygen consumption were higher than those found in the animals in the normal perfusion group ( p < 0.05). Oxygen metabolism was remarkably improved in animals in the dopamine group. Furthermore, cerebral perfusion was better in the dopamine group than in the control group and thus, results of the evaluation of nervous system function were better in animals treated with dopamine ( p < 0.05). Conclusions: Dopamine improved systemic perfusion, cerebral blood supply, and oxygen metabolism after successful resuscitation from VF in a porcine model. All of these factors have profound effects on the cerebral resuscitation.