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Mashup Score: 8Adrenaline and vasopressin for cardiac arrest - PubMed - 3 year(s) ago
This review provides moderate-quality evidence that standard-dose adrenaline compared to placebo improves return of spontaneous circulation, survival to hospital admission and survival to hospital discharge, but low-quality evidence that it did not affect survival with a favourable neurological outc …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet
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Mashup Score: 5Cardiopulmonary arrest - PubMed - 3 year(s) ago
Cardiopulmonary arrest
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
8/ How does epinephrine lead to ROSC? Recall that it works on both α and β receptors. During the first decades of use, many assumed that epinephrine increased cardiac output via β-agonism and that this led to ROSC. https://t.co/mIEkgNjNR0 https://t.co/nQCdMVFJND
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Mashup Score: 4
To determine the relative importance of the alpha and beta adrenergic effects of epinephrine in resuscitation, 32 dogs were studied in four groups. Group A (alpha blocked) received phenoxybenzamine, 70 mg/kg; group B (beta blocked), propranolol 5 mg/kg; group C (alpha and beta blocked) both drugs; a …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
9/ In the late 70s and early 80s, it became clear that the α-agonist effects of epinephrine were actually what mattered. 🔑In an animal study, Otto found that α-blockade before cardiac arrest resulted in a decreased response to CPR and epinephrine. https://t.co/2Qa0Vl3zoX https://t.co/my9lYvueKk
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Mashup Score: 5Prognostic and therapeutic importance of the aortic diastolic pressure in resuscitation from cardiac arrest - PubMed - 3 year(s) ago
A study was done to determine if 12 dogs could be resuscitated from 30 min of ventricular fibrillation if aortic diastolic blood pressure was maintained above 30 mm Hg by administration of epinephrine and, in 6 cases, saline solution during cardiopulmonary resuscitation (CPR). Of the 12 dogs seven w …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
11/ A 1984 study found that increasing SBP did NOT lead to increased survival. But: 🔑Increasing aortic DIASTOLIC blood pressure (AoDBP) was associated with increased survival. Why would AoDBP matter more? https://t.co/aqRMOAbo7u https://t.co/jsFqsYKLmr
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Mashup Score: 7Coronary perfusion pressure and the return of spontaneous circulation in human cardiopulmonary resuscitation - PubMed - 3 year(s) ago
Coronary perfusion pressure (CPP), the aortic-to-right atrial pressure gradient during the relaxation phase of cardiopulmonary resuscitation, was measured in 100 patients with cardiac arrest. Coronary perfusion pressure and other variables were compared in patients with and without return of spontan …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
12/ In 1990, Paradis et al. provided the answer. Their study showed that: 🔑Coronary perfusion pressure (CPP) during CPR strongly predicts ROSC. In this study, the CPPs were: 😀ROSC = 25.6 mmHg ☹️No ROSC = 8.4 mmHg https://t.co/y6tEHhcswa https://t.co/vjXAjkUpR9
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Mashup Score: 4Mechanisms by which epinephrine augments cerebral and myocardial perfusion during cardiopulmonary resuscitation in dogs - PubMed - 3 year(s) ago
The goals of this study were to quantify the effects of epinephrine on myocardial and cerebral blood flow during conventional cardiopulmonary resuscitation (CPR) and CPR with simultaneous chest compression-ventilation and to test the hypothesis that epinephrine would improve myocardial and cerebral …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
14/ We saw in tweet 11 that Epinephrine, via its effect on α-receptors, increases AoDBP. This leads to an increase in CPP. 🔑The increased CPP results in increased rates of ROSC! https://t.co/i1H0rBXeGR https://t.co/BqE0uNIwqH
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Mashup Score: 1
To determine whether epinephrine-induced hypokalemia is due to beta2-adrenoceptor stimulation, and whether hypokalemia can occur at physiologic concentrations of the agonist, epinephrine was infused into six normal volunteers at a rate of 0.1 microgram per kilogram of body weight per minute. The cir …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
3/6 Here's the key: 🔑 Epinephrine can itself cause hypokalemia. This is mediated through β2 receptor activation leading to increased activity of the Na/K-ATPase. https://t.co/EE2GD1JHaw https://t.co/jnfRACWy0E
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Mashup Score: 1
Epinephrine was infused intravenously in 9 normal volunteers to plasma concentrations similar to those found after acute myocardial infarction. This study was undertaken on 3 occasions after 5 days of treatment with placebo or the beta-adrenoceptor antagonist, atenolol, which is relatively beta 1 se …
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
6/6 There's one other interesting connection. If one assume hypothesis #1 to be correct, this may help explain the benefit of β-blockers in AMI. Agents with β2 antagonism will blunt the decrease in potassium seen with epinephrine! https://t.co/H7SoYDg04X https://t.co/QoKcGyCbY6
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Mashup Score: 1THE USE OF EPINEPHRINE AS A DIAGNOSTIC TEST FOR ANGINA PECTORIS - 3 year(s) ago
Some years ago one of us (S. A. L.) was called to see a patient with angina pectoris who was at that time experiencing a severe attack of bronchial asthma. Epinephrine, 0.5 cc, was administered subcutaneously, and after several minutes the patient developed an attack of severe anginal pain. Some…
Source: jamanetwork.comCategories: Hem/Oncs, Latest HeadlinesTweet-
I failed to link to the first paper in this thread. Here it is: https://t.co/Kq7e3ufRbB https://t.co/7yyEFm1nOC
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Mashup Score: 37Landmark article (JAMA 1912). Clinical features of sudden obstruction of the coronary arteries. By James B. Herrick - PubMed - 3 year(s) ago
Landmark article (JAMA 1912). Clinical features of sudden obstruction of the coronary arteries. By James B. Herrick
Source: PubMedCategories: Hem/Oncs, Latest HeadlinesTweet-
1/6 In James Herrick's original description of acute MI in 1912 he wrote that "the importance of absolute rest in bed for several days is clear." This admonition was meant to reduce stress on a necrotic wall and mitigate catastrophic rupture. https://t.co/RjWMIhvXrX https://t.co/Xvmvi5edUT
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7/ In the decades since Crile's work, it has become clear that epinephrine increases the probability of return of spontaneous circulation (ROSC). In one meta-analysis, the rates of ROSC were: ☞ 115 per 1000 for placebo ☞ 329 per 1000 for epinephrine https://t.co/I0oBtOTdUA https://t.co/YdcAvfGIhn