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Alpha-methylnorepinephrine, a selective alpha₂-adrenergic agonist for cardiac resuscitation

Shijie Sun, MD^* , Max Harry Weil, MD, PhD, FACC^* , Wanchun Tang, MD^* , Takashi Kamohara, MD^* and Kada Klouche, MD^*

^* Institute of Critical Care Medicine, Palm Springs, California, USA
Keck School of Medicine of the University of Southern California, Los Angeles, California, USA

View larger version (35K): [in a new window]   Figure 1 Experimental procedures. DF = defibrillation; Drug = either alphaMNE, epinephrine or saline placebo; FiO2 = inspired oxygen fraction; MV = mechanical ventilation; PC = precordial compression; VF = ventricular fibrillation. *For alpha2-receptor block (only in the group of animals which received alpha-methylnorepinephrine during cardiopulmonary resuscitation).

View larger version (28K): [in a new window]   Figure 2 Effects of four interventions on CPP and ETCO2 during precordial compression. Values are mean ± standard deviation. MNE = alpha-methylnorepinephrine; MNE+Y = alpha-methylnorepinephrine pretreated with yohimbine; CPP = coronary perfusion pressure; drug = the time of administration of the drugs; Epi. = epinephrine; ETCO2 = end tidal PCO2; PC = precordial compression. *p < 0.05; **p < 0.01.

View larger version (37K): [in a new window]   Figure 3 Effects of four interventions on postresuscitation dP/dt40. Values are mean ± standard deviation. MNE = alpha-methylnorepinephrine; MNE+Y = alpha-methylnorepinephrine pretreated with yohimbine; BL = baseline; DF = defibrillation; Epi. = epinephrine; PC = precordial compression; VF = ventricular fibrillation. *p < 0.05 vs. epinephrine.

View larger version (36K): [in a new window]   Figure 4 Effects of four interventions on postresuscitation cardiacindex. Values are mean ± standard deviation. MNE = alpha-methylnorepinephrine; MNE+Y = alpha-methylnorepinephrine pretreated with yohimbine; BL = baseline; DF = defibrillation; Epi. = epinephrine; PC = precordial compression; VF = ventricular fibrillation. *p < 0.05; **p < 0.01 vs. epinephrine.

View larger version (36K): [in a new window]   Figure 5 Effects of four interventions on postresuscitation –dP/dt. Values are mean ± standard deviation. MNE = alpha-methylnorepinephrine; MNE+Y = alpha-methylnorepinephrine pretreated with yohimbine; BL = baseline; DF = defibrillation; Epi. = epinephrine; PC = precordial compression; VF = ventricular fibrillation. *p < 0.05; **p < 0.01 vs. epinephrine.

View larger version (35K): [in a new window]   Figure 6 Effects of four interventions on postresuscitation LVDP. Values are mean ± standard deviation. MNE = alpha-methylnorepinephrine; MNE+Y = alpha-methylnorepinephrine pretreated with yohimbine; BL = baseline; DF = defibrillation; Epi. = epinephrine; LVDP = left ventricular end-diastolic pressure; PC = precordial compression; VF = ventricular fibrillation. *p < 0.05; **p < 0.01 vs. epinephrine.