Effect of IV amiodarone on CPR haemodynamics and outcome: experimental study in dogs

Amiodarone has been shown to be superior to placebo in improving admission to hospital for victims of out-of-hospital ventricular fibrillation. There is no data about haemodynamics induced by amiodarone alone or associated with epinephrine. This study compared outcome and haemodynamics of amiodarone alone, epinephrine alone, and the association of these two drugs in a model of resistant ventricular fibrillation in dogs (30 dogs were randomized; 10 to the epinephrine group, 10 to the amiodarone group and 10 to the association group). There were no differences among the groups in baseline variables. Compared to the association, epinephrine produced a better rate of ROSC, resuscitation, and 1-hour survival. There were no differences in outcome between amiodarone and epinephrine or amiodarone and association. Aortic systolic and diastolic, and coronary perfusion pressures were lower in the amiodarone than in the other two groups. Associated to epinephrine, amiodarone produced pressures similar to epinephrine alone. Amiodarone may be used during cardiac arrest, if associated with a vasoconstrictor like epinephrine.