Absorption and Hemodynamic Effects of Airway Administration of Adrenaline in Patients with Severe Cardiac Disease

@article{Raymondos2000AbsorptionAH,
  title={Absorption and Hemodynamic Effects of Airway Administration of Adrenaline in Patients with Severe Cardiac Disease},
  author={Konstantinos Raymondos and Bernhard Panning and Martin Leuwer and G Brechelt and Thomas Korte and Michael Niehaus and Jürgen Tebbenjohanns and Siegfried Piepenbrock},
  journal={Annals of Internal Medicine},
  year={2000},
  volume={132},
  pages={800-803}
}
Endotracheal administration of at least 2 mg of adrenaline is recommended in adults if intravenous access cannot be attained during resuscitation (1). It is an accepted and frequently used alternative to intravenous administration. Studies in animals have suggested that endotracheal doses of adrenaline must be at least 10 times greater than intravenous doses (2, 3). However, three previous studies failed to show any effects after endotracheal administration of 0.03 to 1 mg of adrenaline in… 
Deleterious Airway Administration of Adrenaline
TLDR
It is extremely unlikely that adrenaline administration during cardiac arrest causes any vasodilatory effects that could occur at low adrenaline plasma levels under spontaneous circulation.
Should vasopressin replace adrenaline for endotracheal drug administration?
TLDR
Vasopressin accomplishes its hemodynamic effect, particularly on diastolic blood pressure, more rapidly, vigorously, and protractedly and to a significant degree compared with both endotracheal and endobronchial adrenaline.
Is Endotracheal Adrenaline Deleterious Because of the Beta Adrenergic Effect?
TLDR
Endotracheal adrenaline was associated with predominantly &bgr;-adrenergic–mediated effects, causing hypotension via peripheral vasodilatation unopposed by &agr;- adrenergic vasoconstrictive threshold, and the search for the optimal dose of endotrachal adrenaline should be aimed at achieving the higher &agR;-Adrenergic Vasoconstriction threshold.
Endotracheal Epinephrine: A Call for Larger Doses
TLDR
A prospective, randomized, laboratory comparison of increasing doses of endotracheal epinephrine was conducted to ascertain the yet undetermined optimal dose of endot rachealEpinephrine that would increase BP.
Endotracheal epinephrine: a call for larger doses.
TLDR
Clinical studies using larger doses of endotracheal epinephrine and their use as first-line therapy in cardiac arrest are warranted.
ß1- OR ß2-BLOCKERS TO IMPROVE HEMODYNAMICS FOLLOWING ENDOTRACHEAL ADRENALINE ADMINISTRATION
TLDR
The selective beta-blocker metoprolol was almost as effective as the non-selective beta- blocker propranolol in attenuating the initial decrease in blood pressure following endotracheally administered adrenaline, a phenomenon that was previously attributed to inhibition of beta-adrenoreceptors.
Use and Efficacy of Endotracheal Versus Intravenous Epinephrine During Neonatal Cardiopulmonary Resuscitation in the Delivery Room
TLDR
Endotracheal epinephrine is frequently used when intensive resuscitation is required in the delivery room, and intravenous administration should be the preferred route of delivery.
Cardiopulmonary resuscitation in small animal medicine: an update.
TLDR
Medications utilized in cardiopulmonary resuscitation, including amiodarone, atropine, epinephrine, lidocaine, and vasopressin, along with the indications, effects, routes of administration, and dosages, are discussed.
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