Epinephrine’s effects on cerebrovascular and systemic hemodynamics during cardiopulmonary resuscitation

Mavroudis, Constantine D.; Ko, Tiffany S.; Morgan, Ryan W.; Volk, Lindsay E.; Landis, William P.; Smood, Benjamin; Xiao, Rui; Hefti, Marco; Boorady, Timothy W.; Marquez, Alexandra; Karlsson, Michael; Licht, Daniel J.; Nadkarni, Vinay M.; Berg, Robert A.; Sutton, Robert M.; Kilbaugh, Todd J.

doi:10.1186/s13054-020-03297-4

Critical Care

Table 1 Effects of intra-arrest epinephrine on cerebrovascular and systemic hemodynamics by dose

From: Epinephrine’s effects on cerebrovascular and systemic hemodynamics during cardiopulmonary resuscitation

	Dose 1 (n = 20)		Dose 2 (n = 20)		Dose 3 (n = 9)		Dose 4 (n = 7)		Dose 5 (n = 4)
	Effect size	p	Effect size	p	Effect size	p	Effect size	p	Effect size	p
(Δ, % Baseline)
Invasive rCBF	+ 8.2 [1.1, 22.4]	0.004*	+ 4.3 [1.3, 8.8]	0.002*	+ 3.5 [1.1, 8.0]	0.047	+ 0.9 [0.4, 2.3]	0.156	− 0.0 [− 0.7, 0.4]	0.875
Non-invasive rCBF	+ 17.3 [4.6, 23.6]	0.001*	+ 5.6 [0.4, 16.1]	0.015	+ 6.7 [0.5, 12.2]	0.156	+ 3.8 [− 2.3, 8.1]	0.438	− 3.7 [− 9.1, 3.6]	0.750
rPbtO₂	+ 6.4 [0.6, 18.7]	0.001*	+ 0.3 [− 2.7, 5.0]	0.494	− 0.2 [− 6.1, 1.0]	0.426	− 0.2 [− 2.6, 0.3]	0.578	+ 0.1 [− 1.1, 0.5]	0.875
rStO₂	+ 7.9 [4.1, 12.6]	< 0.001*	+ 3.4 [0.4, 7.0]	< 0.001*	+ 1.8 [− 0.8, 3.3]	0.129	− 1.1 [− 1.8, 2.0]	0.938	− 0.6 [− 2.3, 1.1]	0.625
rTHC	+ 3.0 [1.9, 6.4]	0.001*	+ 1.1 [0.3, 2.0]	0.007*	− 0.4 [− 2.3, 2.0]	> 0.999	+ 0.6 [− 0.5, 1.0]	0.578	− 0.7 [− 1.5, − 0.4]	0.125
r [HbO₂]	+ 11.0 [5.9, 16.1]	< 0.001*	+ 6.0 [0.8, 9.6]	< 0.001*	+ 1.7 [− 1.8, 4.4]	0.250	− 0.9 [− 1.6, 3.3]	0.938	− 0.9 [− 3.1, 1.0]	0.625
r [Hb]	− 2.9 [− 12.1, 0.3]	0.006*	− 2.7 [− 6.2, 0.4]	0.012	− 1.4 [− 4.1, 0.2]	0.098	+ 0.5 [− 1.2, 1.4]	0.938	− 0.8 [− 1.9, − 0.2]	0.250
(Δ, mmHg)
SBP	+ 17.6 [8.4, 52.0]	< 0.001*	+ 16.5 [6.4, 26.0]	< 0.001*	+ 21.0 [1.8, 34.7]	0.027	+ 9.7 [− 3.5, 18.1]	0.156	− 1.6 [− 3.2, 4.3]	0.875
DBP	+ 9.4 [5.0, 13.5]	< 0.001*	+ 5.5 [3.7, 9.0]	< 0.001*	+ 2.8 [1.1, 6.0]	0.012*	+ 2.4 [1.2, 5.4]	0.016*	+ 1.3 [− 0.7, 2.9]	0.625
CPP	+ 8.2 [3.9, 11.7]	< 0.001*	+ 4.5 [2.7, 8.2]	< 0.001*	+ 3.8 [0.9, 6.1]	0.020	+ 2.4 [1.2, 5.2]	0.016	+ 1.3 [− 0.7, 2.7]	0.625

Effect size reported as median [interquartile range]
Abbreviations: Δ change in value, n sample size, rCBF relative cerebral blood flow, rPbtO₂ relative partial pressure of oxygen in brain tissue, rStO₂ relative cerebral tissue oxygen saturation, rTHC relative total hemoglobin concentration, r [HbO₂] relative concentration of oxy-hemoglobin, r [Hb] relative concentration of deoxy-hemoglobin, SBP systolic aortic blood pressure, DBP diastolic aortic blood pressure, CPP coronary perfusion pressure
*Adjusted p < 0.05 after false discovery rate correction for repeated comparisons

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