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Survival with full neurologic recovery and no cerebral pathology after prolonged cardiopulmonary resuscitation with vasopressin in pigs

Volker Wenzel, MD^*, Karl H. Lindner, MD^*,1, Anette C. Krismer, MD^*, Wolfgang G. Voelckel, MD^*, Michael F. Schocke, MD, Wolfgang Hund, BS^* , Markus Witkiewicz, RN, BS^*, Egfried A. Miller, BS^*, G.ünter Klima, MD, J.örg Wissel, MD, Werner Lingnau, MD^* and Franz T. Aichner, MD^*

^* Departments of Department of Anesthesiology and Critical Care Medicine, The Leopold-Franzens-University of Innsbruck, Innsbruck, Austria
Department of Histology, The Leopold-Franzens-University of Innsbruck, Innsbruck, Austria
Department of Neurology and, The Leopold-Franzens-University of Innsbruck, Innsbruck, Austria
Department of Magnetic Resonance and Spectroscopy, The Leopold-Franzens-University of Innsbruck, Innsbruck, Austria

View larger version (18K): [in a new window]   Figure 1 Diastolic aortic pressure during CPR. Repeated doses of vasopressin (line with diamonds) but not epinephrine (line with squares) or saline placebo (line with triangles) maintained the mean value ±SEM of aortic diastolic blood pressure above a threshold of 30 to 40 mm Hg (horizontal dashed lines), which makes successful defibrillation likely. *p < 0.05 vs. epinephrine and saline placebo. p < 0.05 vs. saline placebo. ACLS = advanced cardiac life support; BLS = basic life support; DA 1 = drug administration of 0.4 U/kg vasopressin vs. 45 µg/kg epinephrine vs. saline placebo; DA 2 = drug administration of 0.4 U/kg vasopressin vs. 45 µg/kg epinephrine vs. saline placebo; DA 3 = drug administration of 0.8 U/kg vasopressin vs. 200 µg/kg epinephrine vs. saline placebo. VF = ventricular fibrillation. Time is given in minutes (') and seconds ('').

View larger version (187K): [in a new window]   Figure 2 Representative axial cerebral T2-weighted MRI (showing occipital cortex and the basal ganglia) of a pig resuscitated with vasopressin after 96 h of survival.

View larger version (173K): [in a new window]   Figure 3 Representative coronary cerebral T2-weighted MRI (showing parietal and temporal cortex and the basal ganglia) of a pig resuscitated with vasopressin after 96 h of survival.