Administration of glucagon and epinephrine may improve survival of cardiac arrest induced by ventricular fibrillation - experimental model.

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 pritiska 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