Semenas, E

Wiklund, L

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Scandinavian Journal of Trauma, 
Resuscitation and Emergency Medicine
Open AccessOral presentation
Adrenalin significantly increases intracranial pressure in 
hypovolemic cardiac arrest model in male piglets
E Semenas* and L Wiklund
Address: Department of Surgical Sciences/Anaesthesiology and Intensive Care Medicine, University Hospital, Uppsala, Sweden
Email: E Semenas* - egidijus.semenas@gmail.com
* Corresponding author    
Introduction
Resuscitation from hemorrhagic shock and subsequent
cardiac arrest (CA) is a major clinical challenge in the care
of trauma patients [1]. We hypothesized that adrenalin
given during cardiopulmonary resuscitation (CPR) will
improve cerebral perfusion response in hypovolemic car-
diac arrest.
Methods
Twenty-one anesthetized male piglet (with a weight 24.3
± 1.3 kg) were bled 35% via femoral artery to a mean arte-
rial blood pressure of 25 mm Hg during 15 min. Later pig-
lets were subjected to 8 mins untreated ventricular
fibrillation followed by 15 min open-chest CPR. At 9 min
of CA piglets received amiodarone 1.0 mg/kg and hyper-
tonic-hyperoncotic solution 4 ml/kg infusion for 20 min-
utes. At the same time vasopressin 0.4 U/kg was given
intravenously to vasopressin group (VAS, n = 9), while
adrenalin group received adrenalin 20 μg/kg (ADR, n =
12). Internal defibrillation was attempted from 11 min of
CA to achieve restoration of spontaneous circulation
(ROSC). Experiment was terminated at 3 hours after
resuscitation.
Results
No significant differences were observed in resuscitability/
survival between the groups. There were no significant dif-
ferences in cerebral cortical blood flow or protein S-100β
levels after ROSC between the groups. Intracranial pres-
sure was significantly higher in ADR group compared with
VAS group in the post resuscitation phase. Jugular bulb
pH and base excess was higher in the ADR group 15 (p =
0.0003 and p = 0.0002) and 30 min after ROSC in com-
parison with the VAS group (p = 0.02 and p = 0.001).
Besides, oxygen extraction in jugular bulb samples was
greater in the VAS group compared with the ADR group at
the same time points (p = 0.03 and p = 0.003, respec-
tively).
Conclusion
Resuscitation with adrenalin significantly increased
intracranial pressure though improvement of cerebral per-
fusion was reflected by higher jugular bulb pH, base
excess and lower oxygen extraction ratio with no signifi-
cant changes in cerebral cortical blood flow.
References
1. Lockey D, Crewdson K, Davies G: Ann Emerg Med 2006, 48(3):240-4.
from Scandinavian Update on Trauma, Resuscitation and Emergency Medicine 2009
Stavanger, Norway. 23 – 25 April 2009
Published: 28 August 2009
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2009, 17(Suppl 3):O7 doi:10.1186/1757-7241-17-S3-O7
<supplement> <title> <p>Scandinavian Update on Trauma, Resuscitation and Emergency Medicine 2009</p> </title> <editor>Hans Morten Lossius, Eldar Søreide and Kjetil G Ringdal</editor> <sponsor> <note>Publication of this supplement was supported by Akuttjournalen Arena AS</note> </sponsor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1757-7241-17-S3-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/pdf/1757-7241-17-S3-info.pdf</url> </supplement>
This abstract is available from: http://www.sjtrem.com/content/17/S3/O7
© 2009 Semenas and Wiklund; licensee BioMed Central Ltd. 


Adrenalin significantly increases intracranial pressure in hypovolemic cardiac arrest model in male piglets

E Semenas

L Wiklund

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Wiklund L

Semenas E

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Scandinavian Journal of Trauma Resuscitation and Emergency Medicine

Ann Emerg Med 2006, 48(3):240-4. from Scandinavian Update on Trauma, Resuscitation and Emergency Medicine

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Adrenalin significantly increases intracranial pressure in hypovolemic cardiac arrest model in male piglets

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