Epinephrine increases
coronary perfusion pressure by decreasing blood flow to all other organs, an effect that may persist after the restoration of pulses.[sup][12] On the basis of observational data and limited clinical trials, standard-dose epinephrine does not increase and may actually reduce long-term survival and neurological recovery after CPR.[sup][11] Potentially harmful effects are a- and [sz]-receptor mediated and include reduced cerebral microvascular blood flow and exacerbation of neurological outcome.
Effects of Ang-(1-7) (2 x [10.sup.-11] M) on
coronary perfusion pressure in isolated perfused hearts from rats that underwent aortic banding (AB) and were (A) untreated or chronically treated with (B) losartan, (C) amlodipine, (D) captopril, or (E) spironolactone (5 mg x [kg.sup.-1] x [day.sup.-1]).
High-quality compressions and
coronary perfusion pressures correlate with end-tidal carbon dioxide (ETCO2) levels of 20-25 mm Hg on capnography.
Secondarily, IABP improves cardiac output, increases
coronary perfusion pressures, increases systemic perfusion, reduces mitral regurgitation and reduces afterload, which will subsequently decrease left ventricular workload.
New data suggest that the two-thumb technique generates higher peak systolic and
coronary perfusion pressures and that providers prefer it.