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The effects of sternal and intravenous vasopressin administration on pharmacokinetics

Donald J. Vallier, BSN, Ashley D. Torrence, BSN, Robinson Stevens III, BSN, Peta Noreen Arcinue, BSN, Don Johnson, PhD

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.


Keywords


intraosseous, vasopressin, shock, arrest

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References


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DOI: https://doi.org/10.5055/ajdm.2016.0240

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