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<p>Vasopressin may improve blood flow during cardiopulmonary resuscitation (CPR) in hyperkalemic cardiac arrest. This could enhance the delivery of antihyperkalemic treatments and improve potassium-lowering effects and resuscitation outcomes. We assessed the effects of vasopressin and epinephrine, with and without antihyperkalemic treatments, on hemodynamics, laboratory parameters, and return of spontaneous circulation (ROSC) in a porcine model of hyperkalemic cardiac arrest. After inducing hyperkalemic cardiac arrest with potassium administration, 40 pigs were randomized into four groups: (1) epinephrine + saline placebo, (2) epinephrine + antihyperkalemic treatments, (3) vasopressin + saline placebo, and (4) vasopressin + antihyperkalemic treatments. Vasopressin (<i>P</i> = 0.004) and antihyperkalemic treatments (<i>P</i> = 0.042) significantly improved coronary perfusion pressure (CoPP) during CPR compared to epinephrine and saline placebo, respectively. Neither showed differences in potassium concentration during CPR compared to their respective controls. There was no significant interaction between vasopressor type and antihyperkalemic treatments for CoPP or potassium levels. Vasopressin and antihyperkalemic treatments significantly increased the odds of ROSC compared to epinephrine and saline placebo, respectively (both <i>P</i> = 0.017), with the highest ROSC rate in the combined treatment group. In conclusion, vasopressin improved ROSC through superior CoPP compared to epinephrine, without enhancing the potassium-lowering effects of antihyperkalemic treatments.</p>

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Effects of vasopressin and antihyperkalemic treatments on hemodynamics, potassium concentration, and resuscitation success in a porcine hyperkalemic cardiac arrest model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月2日

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  • Wan Young Heo,
  • Hyoung Youn Lee,
  • Najmiddin Mamadjonov,
  • Hussain Ahmad,
  • Yeon Heo,
  • Yong Hun Jung,
  • Seok Jin Ryu,
  • Byung Kook Lee,
  • Kyung Woon Jeung

摘要

Vasopressin may improve blood flow during cardiopulmonary resuscitation (CPR) in hyperkalemic cardiac arrest. This could enhance the delivery of antihyperkalemic treatments and improve potassium-lowering effects and resuscitation outcomes. We assessed the effects of vasopressin and epinephrine, with and without antihyperkalemic treatments, on hemodynamics, laboratory parameters, and return of spontaneous circulation (ROSC) in a porcine model of hyperkalemic cardiac arrest. After inducing hyperkalemic cardiac arrest with potassium administration, 40 pigs were randomized into four groups: (1) epinephrine + saline placebo, (2) epinephrine + antihyperkalemic treatments, (3) vasopressin + saline placebo, and (4) vasopressin + antihyperkalemic treatments. Vasopressin (P = 0.004) and antihyperkalemic treatments (P = 0.042) significantly improved coronary perfusion pressure (CoPP) during CPR compared to epinephrine and saline placebo, respectively. Neither showed differences in potassium concentration during CPR compared to their respective controls. There was no significant interaction between vasopressor type and antihyperkalemic treatments for CoPP or potassium levels. Vasopressin and antihyperkalemic treatments significantly increased the odds of ROSC compared to epinephrine and saline placebo, respectively (both P = 0.017), with the highest ROSC rate in the combined treatment group. In conclusion, vasopressin improved ROSC through superior CoPP compared to epinephrine, without enhancing the potassium-lowering effects of antihyperkalemic treatments.