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This Article Full Text Full Text (PDF) All Versions of this Article: 287/2/H969    most recent 01171.2003v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (9) Citing Articles via Google Scholar Google Scholar Articles by Sun, S. Articles by Klouche, K. Search for Related Content PubMed PubMed Citation Articles by Sun, S. Articles by Klouche, K.

-Opioid receptor agonist reduces severity of postresuscitation myocardial dysfunction

¹Institute of Critical Care Medicine, Palm Springs, 92262; and ²Keck School of Medicine, University of Southern California, Los Angeles, California 90089

Submitted 9 December 2003 ; accepted in final form 18 March 2004

Postresuscitation myocardial dysfunction is recognized as a leading cause of early death after initially successful cardiopulmonary resuscitation (CPR). In the present study, we hypothesized that a -opioid receptor agonist would decrease the severity of postresuscitation myocardial dysfunction and improve survival. Fifteen Sprague-Dawley rats, fasted overnight with access to water, were anesthetized by an injection of 45 mg/kg ip pentobarbital sodium. Additional doses of 10 mg/kg were administered at hourly intervals but not within 30 min before induced ventricular fibrillation (VF). Either the -opioid receptor agonist pentazocine (300 µg/kg), pentazocine pretreated with the opioid receptor-blocking agent naloxone (1 mg/kg), or saline placebo was injected into the right atrium after 5 min of untreated VF and 3 min before initiation of CPR. After an additional 8 min of CPR administration, defibrillation was attempted. All animals were successfully resuscitated. Left ventricular rate of pressure increase at 40 mmHg and cardiac index values were significantly improved in pentazocine-treated animals, which also had significantly longer survival times (60 ± 11 vs. 16 ± 7 h; P < 0.01). Except for ease of defibrillation, the beneficial effects of pentazocine were completely abolished by pretreatment with naloxone. The concept of pharmacological hibernation employing a -opioid receptor agonist is a novel and promising intervention for minimizing global ischemic injury during CPR and postresuscitation myocardial dysfunction.

cardiac arrest; cardiopulmonary resuscitation; hibernation; ventricular fibrillation; rat

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