To determine the value of sodium bicarbonate in resuscitation from ventricular fibrillation and the prevention of spontaneous refibrillation, sodium bicarbonate (1 meq/kg) or placebo was administered on a random basis to 16 pentobarbital-anaesthetized dogs 18 min after the induction of ventricular fibrillation and cardiopulmonary resuscitation. Defibrillation was attempted 2 min after the administration of bicarbonate or placebo. All animals were successfully defibrillated, but three of eight bicarbonate-treated and two of eight control animals died in electromechanical dissociation (p=NS). Spontaneous refibrillation occurred in three animals in each group (p=NS). Successful resuscitation was not dependent on treatment, arterial or mixed venous PCO2, or arterial or mixed venous pH but correlated strongly with coronary perfusion pressure (p<.003). Spontaneous refibrillation occurred without relation to any identifiable variable. The gradient between diastolic aortic and right atrial pressures was 24 ± 2 mm Hg in controls and 23 ± 2 mm Hg in treated animals over the entire 20 min of cardiopulmonary resuscitation (p=NS). However, among animals successfully resuscitated, mean diastolic coronary perfusion pressure averaged 27 ± 2 mm Hg compared with 20 ± 1 mm Hg among those dying in electromechanical dissociation (p<0.02). For the final 2 min of resuscitation, after drug administration, these gradients were 31 ± 2 and 23 ± 2 mm Hg, respectively (p<.01). Microsphere determined myocardial perfusion correlated with the diastolic aortic-right atrial perfusion pressure gradient (r=.86) and was 0.43 ± 0.03 ml/min/g in survivors and 0.22 ± 0.01 ml/min/g in nonsurvivors (p<.01). These data do not suggest a primary role for sodium bicarbonate in the treatment of ventricular fibrillation. Efforts should be made to maximize coronary perfusion pressure during cardiopulmonary resuscitation.
|Original language||English (US)|
|Issue number||6 II MONOGR. 126|
|State||Published - Dec 1 1986|
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)