PLASMA-CATECHOLAMINE CONCENTRATIONS AFTER SUCCESSFUL RESUSCITATION IN PATIENTS

Objectives. To measure plasma catecholamine concentrations after cardiopulmonary resuscitation (CPR) and to correlate catecholamine concentrations with heart rate (HR), BP, and plasma glucose and lactate concentrations. Design: Prospective, descriptive study. Setting: Emergency medical service at a University Hospital. Patients: Ten patients (58 to 85 yrs) with out-of-hospital cardiac arrest. Interventions: At 1, 5, 15, 30, and 60 mins after restoration of spontaneous circulation, blood samples were drawn and BP and HR were measured.Plasma catecholamine concentrations were measured by high-pressure liquid chromatography and plasma glucose and lactate concentrations were measured by enzymatic methods. Main Results: Median plasma epinephrine and norepinephrine concentrations were 136.3-mu-g/L (136,300 pg/mL), range 27.6 to 397.6-mu-g/L (27,600 to 397,600 pg/mL), and 4.7-mu-g/L (4700 pg/mL), range 1.8 to 14.5-mu-g/L (1 800 to 14,500 pg/mL), respectively, at 1 min. Median plasma epinephrine and norepinephrine concentrations decreased to 8.7-mu-g/L (8700 pg/mL), range 1.2 to 55.0-mu-g/L (1200 to 55,000 pg/mL) and 1.9-mu-g/L (1900 pg/mL), range 1.3 to 5.8-mu-g/L (1300 to 5800 pg/mL), respectively, at 60 mins after restoration of spontaneous circulation. Epinephrine concentrations decayed with a semilogarithmic decay pattern. The half-life for the alpha-phase was 2.2 mins and was 38.7 mins for the beta-phase. Mean values of systolic arterial pressure were between 136 +/- 23 mm Hg at 1 min and 120 +/- 15 mm Hg at 30 mins. Median plasma glucose concentrations were between 8.2 mmol/L (147.7 mg/dL; range 5.8 to 11.2 mmol/L [104.5 to 201.8 mg/dL]) at 1 min and 13.9 mmol/L (250.4 mg/dL; range 9.7 to 16.6 mmol/L [174.8 to 299.1 mg(dL]) at 30 mins. Lactate values were between 11.4 mmol/L (range 4.7 to 16.5) at 1 min and 5.2 mmol/L (range 2.7 to 12.5) at 60 mins. No significant correlations were found between circulating catecholamine concentrations and the other variables. Conclusions: After CPR, plasma catecholamine concentrations remained at high values but they did not lead to increases in BP, HR, or circulating glucose concentrations.