The effects of sternal and intravenous vasopressin administration on pharmacokinetics.

Abstract

OBJECTIVE:

Purposes of this study were to compare intravenous (IV) and sternal intraosseous (SIO) administration of vasopressin relative to concentration maximum (Cmax), time to maximum concentration (Tmax), and mean concentration in a cardiac arrest model.

DESIGN:

Prospective, between subjects, randomized experimental design.

SETTING:

Vivarium.

SUBJECTS:

Yorkshire-cross swine (N = 16) INTERVENTION: Swine were anesthetized, placed into cardiac arrest, and after 2 minutes, cardiopulmonary resuscitation was initiated. After additional 2 minutes, 40 units of vasopressin was administered either by SIO or IV route. Blood samples were collected over 4 minutes. Cmax and means were analyzed using high-performance liquid chromatography tandem mass spectrometry.

MAIN OUTCOME MEASUREMENTS:

Cmax, Tmax, and mean plasma concentrations.

RESULTS:

There were no significant differences in the SIO and IV groups in Cmax (p = 0.96) or Tmax (p = 0.27). The IV and SIO group had a mean Cmax of 68,151 ± SD 21,534 and 69,034 ± SD 40,169 pg/mL, respectively. The IV and SIO vasopressin groups had a mean Tmax of 105 ± SD 39 and 80 ± SD 41 seconds, respectively.

CONCLUSION:

A multivariate analyses of variance indicated that there were no statistically significant differences in pretest data, Cmax, and Tmax; a repeated analyses of variance indicated that there were no significant differences between the groups relative to mean concentrations of serum vasopressin over time (p > 0.05).

CONCLUSION:

When a patient is in cardiac arrest, it is essential to establish rapid and reliable access to blood vessels so that life-saving drugs can be administered and the SIO provides such a route.

• Authors: Donald J Vallier, Ashley D Torrence, Robinson Stevens 3rd, Peta Noreen Arcinue, Don Johnson
• Journal: American journal of disaster medicine (Am J Disaster Med) Vol. 11 Issue 3 Pg. 203-209 ( 2016) ISSN: 1932-149X [Print] United States
• PMID: 28134419 (Publication Type: Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Vasoconstrictor Agents
• Vasopressins

Topics

• Animals
• Cardiopulmonary Resuscitation (methods)
• Chromatography, High Pressure Liquid
• Disease Models, Animal
• Heart Arrest (therapy)
• Infusions, Intraosseous (methods)
• Infusions, Intravenous (methods)
• Male
• Multivariate Analysis
• Prospective Studies
• Random Allocation
• Sternum
• Sus scrofa
• Swine
• Tandem Mass Spectrometry
• Vasoconstrictor Agents (administration & dosage, pharmacokinetics)
• Vasopressins (administration & dosage, pharmacokinetics)