What is the clinical evidence from this study?

Study design: RCT. Population: Asphyxial or ventricular fibrillation cardiac arrest (n=49). Intervention: Norepinephrine vs. Epinephrine (45 micrograms/kg) or placebo. Primary outcome: Resuscitation time and restoration of spontaneous circulation.

What does this research mean for the field?

In a porcine model of ventricular fibrillation cardiac arrest, norepinephrine is superior to an equivalent dose of epinephrine with respect to resuscitation time. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the efficacy of epinephrine versus norepinephrine in facilitating resuscitation after asphyxial or ventricular fibrillation cardiac arrest.

May 1, 1989Critical Care Medicine

Comparison of epinephrine and norepinephrine in the treatment of asphyxial or fibrtllatory cardiac arrest in a porcine model

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Key result

Norepinephrine cuts resuscitation time ~87% versus epinephrine in cardiac arrest.

n=49

Why the study?

There were no recent reports on the effectiveness of norepinephrine in the treatment of cardiac arrest, prompting investigation of epinephrine versus norepinephrine in a porcine model of asphyxial or ventricular fibrillation cardiac arrest.

Does norepinephrine improve resuscitation success and time compared to epinephrine in a porcine model of cardiac arrest?

Comparison

45 micrograms/kg epinephrine vs 45 micrograms/kg norepinephrine vs placebo or no drug

Design

Blind preclinical randomized controlled trial

Follow-up

Immediate post-resuscitation

Authors

KLKarl H. LindnerInnsbruck Medical University FAFRIEDRICH W. AHNEFELDUniversität Ulm

Discussion

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Implication

Animal data on norepinephrine in cardiac arrest warrant cautious interpretation; leaves open comparative efficacy versus epinephrine in humans.

Key Points

To compare the efficacy of epinephrine versus norepinephrine in facilitating resuscitation after asphyxial or ventricular fibrillation cardiac arrest.
Porcine models underwent either 3 minutes of asphyxial cardiac arrest or 4 minutes of ventricular fibrillation cardiac arrest.
Interventions were administered blindly: 45 µg/kg epinephrine, 45 µg/kg norepinephrine, or control conditions (placebo or CPR/shocks without drugs) with n=7 animals per treatment arm.
In asphyxial arrest, restoration of circulation occurred in 7 of 7 animals given epinephrine in 174 ± 53 seconds versus 6 of 7 given norepinephrine in 473 ± 116 seconds, compared to 0 of 7 placebo controls.
In ventricular fibrillation, restoration of circulation occurred in all 7 of 7 animals receiving norepinephrine in 86 ± 18 seconds compared to 6 of 7 receiving epinephrine in 667 ± 216 seconds and 0 of 14 across non-drug control arms.

Study Design

Type

RCT (n=49)

Blinding

Blind

Structured PICO

Does norepinephrine improve resuscitation success and time compared to epinephrine in a porcine model of cardiac arrest?

Population

49 pigs in a model of asphyxial or ventricular fibrillation cardiac arrest.

Intervention

Norepinephrine 45 micrograms/kg

Comparator

Epinephrine 45 micrograms/kg, placebo, or CPR/countershocks alone

Outcome

Resuscitation success and time to restoration of spontaneous circulationhard clinical

In a porcine model of ventricular fibrillation cardiac arrest, norepinephrine significantly reduced resuscitation time compared to epinephrine, though epinephrine was more effective in asphyxial arrest.

Cite This Study

Lindner et al. (1989) conducted an RCT in Asphyxial or ventricular fibrillation cardiac arrest (n=49). Norepinephrine vs. Epinephrine (45 micrograms/kg) or placebo was evaluated on Resuscitation time and restoration of spontaneous circulation. In a porcine model of ventricular fibrillation cardiac arrest, norepinephrine was superior to the same dose of epinephrine with respect to resuscitation time (86 vs 667 seconds).

synapsesocial.com/papers/6ab23b3a019f59a1a0ca5153 https://doi.org/10.1097/00003246-198905000-00012

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Implication

Animal data on norepinephrine in cardiac arrest warrant cautious interpretation; leaves open comparative efficacy versus epinephrine in humans.

Comparison of epinephrine and norepinephrine in the treatment of asphyxial or fibrtllatory cardiac arrest in a porcine model

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Comparison of epinephrine and norepinephrine in the treatment of asphyxial or fibrtllatory cardiac arrest in a porcine model

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider