Uticaj primene glukagona i adrenalina na ishod srčanog zastoja izazvanog fibrilacijom komora - eksperimentalni model
Administration of glucagon and epinephrine may improve survival of cardiac arrest induced by ventricular fibrillation - experimental model.
Author
Raffay, ViolettaMentor
Jevđić, JasnaCommittee members
Jakovljević, VladimirRosić, Mirko
Miličić, Biljana
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Show full item recordAbstract
Srčani zastoj se i danas smatra ugrentim stanjem, obeshrabrujućeg
ishoda. Cilj istraživanja bio je da se ispita da li kombinacija adrenalina i
glukagona može poboljšati uspešnost 48h preživljavanja i neurološki ishod,
u odnosu na davanje samog adrenalina, tokom ventrikularne fibrilacije (VF).
Materijal i metod istraživanja: VF je indukovana u 20 belih Landrace/Large
prasića, koje su ostavljene netretirane tokom 8 minuta. Životinje su bile
randomizovane u dve grupe po 10 životinja . Kontrolna grupa životinja je
dobila adrenalin, dok je studijskoh grupi životinja dat adrenalin i glukagon.
Defibrilacija je bila isporučena 10 minuta, nakon vetrikularne fibrilacije.
Sve životinje su oživljavane u skladu sa Preporukama Evropskog
Resuscitacionog Saveta iz 2010. godine.
Rezultati: Povratak spontane cirkulacije (ROSC) je postignut kod 8
životinja (80%) kontrolne grupe i 10 životinja (100%) studijske grupe
(p=0.198). Primećen je značajni postepeni porast koronarnog perfuzionog
prit...iska kao i dijastolnog arterijskog pritiska prvog minuta od započinjanja
kardiopulmonalne resuscitacije. U tri životinje kontrolne grupe (30%) i 9
životinja (90%) studijske grupe postignuto je 48h preživljavanje (p=0.006).
Neurološki pregled je doneo znatno bolje rezultate kod studijske grupe
(p<0.001).
Zaključak: U toku ove eksperimentalne studije, tokom srčanog zastoja po tipu
ventrikularne fibrilacije, dodavanje glukagona adrenalinu je održalo
povišen koronarni perfuzioni pritisak i hemodinamske parametre, tokom
resuscitacije i post-arestnog perioda koje je rezultovalo povećanim
preživljavanjem i intaktnim neurološkim ishodom.
Cardiac arrest is still a daunting medical emergency. The
aim of this study was to investigate can the combination of epinephrine and glucagon
improve initial resuscitation success, 48-hour survival, and neurologic outcome
compared with epinephrine alone, during the ventricular fibrillation (VF).
Material and Methods: VF was induced in 20 healthy Landrace/Large White piglets.
They were subsequently left untreated for 8 minutes. The animals were randomized in
two groups with 10 animals in each. Animal in the control group were received
adrenaline alone, while animals in the study group were received adrenaline and
glucagon. The defibrillation has been delivered in 10th minute of ventricular
fibrillation. All animals were resuscitated according to the European Resuscitation
Council guidelines from 2010. End points were to return of spontaneous circulation
(ROSC) or the persisting asystole.
Results: ROSC was achieved in 8 animals (80%) in the control group and 10 animals
(100...%) in the study group (p=0.198). A significant gradual increase in coronary
perfusion pressure and diastolic aortic pressure over time which started one minute
after the onset of cardiopulmonary resuscitation has been observed. Three animals
(30%) from the control group and 9 animals (90%) from the study group survived
after 48 hours (p=0.006). The neurological examination was significantly better in the
animals of the study group (p<0.001).
Conclusion: In this study of prolonged VF cardiac arrest, the additional
administration of glucagon to epinephrine maintained elevated CPP and
hemodynamic during CPR and post-cardiac arrest period resulted in increased
survival and intact neurological outcome.