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Journal of The Korean Society of Emergency Medicine 1995;6(1): 205-213. |
| PLASMA CATECHOLAMINE RESPONSE TO EXOGENOUS EPINEPHRINE IN CARDIAC ARREST HUMAN |
| Sung Oh Hwang, Young Sik Kim, Kyung Soo Lim, Boo Soo Lee, Kang Hyun Lee, Sun Man Kim, Jin Woong Lee, Jong Cheon Lim, Hyun Kim |
| Department of Emergency Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea |
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Published online: June 30, 1995. |
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| ABSTRACT |
Background
Cardiac arrest is a potent stimulus for the release of endogenous catecholamine and high plasma catecholamine concentration has been reported during cardiopulmonary resuscitation(CPR). Few data were present about the clinical effect of high plasma catecholamine and endogenous catecholamine response to exogenous epinephrine administration during CPR.
Purpose
: This study was designed to evaluate endogenous catecholamine response to cardiac arrest and exogenously administered epinephrine during CPR.
Method : In 21 cardiac arrest victims, blood sample for epinephrine and norepinephrine was drawn before and 1 minute after each epinephrine administration during CPR. 1mg of epinephrine was administered immediately after intravenous access and 3 minute interval during CPR. Plasma catecholamines were quantitated by high-performance liquid chromatography.
Result : Baseline plasma epinephrine concentraqtion was higher in patients with cardiac arrest than normal controls (985 ±1627 vs 194 土137 pg/ml, p<0.05). Baseline plasma norepinephrine concentration was also elevated in patients with cardiac arrest than normal controls, although statistically insignificant(1965 士 4915 vs 360 土 250 pg/ml).
Plasma epinephrine concentration in cardiac arrest patients was significantly elevated after exogenous administration of epinephrine, but its response was blunted after the third dose of epinephrine. Plasma norepinephrine concentration in cardiac arrest patients was also elevated, but its response was observed only after the first epinephrine administration. Plasma epinephrine concentration was persistently higher in patients with return of spontaneous circulation (ROSC) than patients without ROSC. there was no significant difference of plasma norepinephrine concentration whether spontaneous circulation was restored or not. Endogenous epinephrine response to exogenous epinephrine was not observed in patients having prolonged arrest time over 20 minutes.
Conclusion
Results of this study suggests that significant amount of catecholamine is re leased by exogenous epinephrine administration in spite of high plasma catecholamine concentration, and degree of endogenous catecholamine response influences resuscitation outcome.
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| Key words:
Cardiac Arrest, Catecholamine, Cardiopulmonary Resuscitation |
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