The Effect of Sodium Bicarbonate Administration on the Vasopressor Effect of High-Dose Epinephrine During Cardiopulmonary Resuscitation in Swine

Sodium bicarbonate is administered during cardiopulmonary resuscita-tion (CPR) for the treatment of systemic acidemia. However, the effect of administering standard-dose sodium bicarbonate on the vasopressor ef-fect of epinephrine is unknown. This study compared the effects of sodium bicarbonate or normal saline on the vasopressor effect of epinephrine in 16 pigs. After 10 minutes of unassisted ventricular fibrillation, CPR was started using a pneumatic chest compression device. Two minutes after the start of CPR, sodium bicarbonate (1 mEq/kg) or normal saline (1 mL/kg) was administered into the right ventricle foltowed 1 minute later by epinephrine (0.2 mg/kg). Defibrillation was attempted at 8 minutes of CPR (18 minutes of ventricular fibrillation). Results demonstrated no significant differences in aortic systolic, aortic diastolic, or coronary per-fusion pressure (CPP) between the two groups (1 minute after epineph-rine, CPP was 22.8 + 13.3 mm Hg versus 21.1 + 20.7 mm Hg for the sodium bicarbonate and normal saline groups, respectively). However