Effects of early amiodarone administration during and immediately after cardiopulmonary resuscitation in a swine model

Acta Anaesthesiol Scand. 2014 Jan;58(1):114-22. doi: 10.1111/aas.12226. Epub 2013 Nov 1.


Background: Aim of this experimental study was to compare haemodynamic effects and outcome with early administration of amiodarone and adrenaline vs. adrenaline alone in pigs with prolonged ventricular fibrillation (VF).

Methods: After 8 min of untreated VF arrest, bolus doses were administered of adrenaline (0.02 mg/kg) and either amiodarone (5 mg/kg) or saline (n = 8 per group) after randomisation. Cardiopulmonary resuscitation (CPR) was commenced immediately after drug administration, and defibrillation was attempted 2 min later. CPR was resumed for another 2 min after each defibrillation attempt, and the same dose of adrenaline was given every 4th minute during CPR. Haemodynamic monitoring and mechanical ventilation continued for 6 h after return of spontaneous circulation (ROSC), and the pigs were euthanised at 48 h. Researchers were blinded for drug groups throughout the study.

Results: There was no difference in rates of ROSC and 48-h survival with amiodarone vs. saline (5/8 vs. 7/8 and 0/8 vs. 3/8, respectively). Diastolic aortic pressure and coronary perfusion pressure were significantly lower with amiodarone during CPR and 1 min after ROSC (P < 0.05). The number of electric shocks required for terminating VF, time to ROSC and adrenaline dose were significantly higher with amiodarone (P < 0.01). The incidence of post-resuscitation tachyarrhythmias tended to be higher in the saline group (P = 0.081).

Conclusion: Early administration of amiodarone did not improve ROSC or 48-h survival rates, and was associated with worse haemodynamics in this swine model of cardiac arrest.

MeSH terms

  • Amiodarone / therapeutic use*
  • Animals
  • Anti-Arrhythmia Agents / therapeutic use*
  • Cardiopulmonary Resuscitation / methods*
  • Electric Countershock
  • Epinephrine / pharmacology
  • Female
  • Heart Arrest / drug therapy*
  • Heart Arrest / physiopathology
  • Hemodynamics / physiology
  • Odds Ratio
  • Respiration, Artificial
  • Resuscitation
  • Shock / etiology
  • Shock / therapy
  • Swine
  • Vasoconstrictor Agents / pharmacology


  • Anti-Arrhythmia Agents
  • Vasoconstrictor Agents
  • Amiodarone
  • Epinephrine