Administration of Amiodarone During Resuscitation Is Associated with Higher Tumor Necrosis Factor-alpha Levels in the Early Postarrest Period in the Swine Model of Ischemic Ventricular Fibrillation

作者：Youngquist Scott T^*; Niemann James T; Shah Atman P; Thomas Joseph L; Ro**orough John P

来源：Journal of Interferon and Cytokine Research, 2013, 33(6): 292-296.

DOI：10.1089/jir.2012.0123

To compare the early postarrest inflammatory cytokine response between animals administered amiodarone (AMIO) and lidocaine (LIDO) intra-arrest during resuscitation from ventricular fibrillation (VF). Domestic swine (n = 32) were placed under general anesthesia and instrumented before spontaneous VF was induced by balloon occlusion of the left anterior descending coronary artery. After 7 min of VF, standard ACLS resuscitation was performed and animals were randomized to either bolus AMIO (5 mg/kg, n = 13) or LIDO (1 mg/kg, n = 14) for recurrent or refractory VF. A non-antiarrhythmic (n = 5) was also used for comparison. Following return of spontaneous circulation (ROSC), tumor necrosis factor (TNF)-alpha levels were drawn at 30 and 60 min. Groups were comparable with respect to prearrest hemodynamics and resuscitation variables. In the postarrest period, the LIDO and non-antiarrhythmic group demonstrated virtually identical TNF-alpha response trajectories. However, TNF-alpha levels were significantly higher in AMIO- than LIDO-treated animals at 30 min (geometric mean 539 versus 240 pg/mL, 2.2-fold higher, 95% confidence interval [CI] 1.3-3.8-fold higher, P = 0.003) and at 60 min (geometric mean 570 versus 204 pg/mL, 2.8-fold higher, 95% CI 1.1-7.0-fold higher, P = 0.03). Significant differences in the postarrest TNF-alpha levels were observed between animals treated with AMIO as compared to those treated with LIDO. Improved rates of ROSC seen with AMIO may come at the expense of a heightened proinflammatory state in the postcardiac arrest period.

• 出版日期2013-6