Comparison of resuscitative protocols for bupropion overdose using lipid emulsion in a swine model

Abstract

Aims: The aim of this study was to investigate the effects of different treatment combinations on bupropion recovery as well as time to return of spontaneous circulation. Methods: We conducted an eight group, randomized, experiment to evaluate combinations of epinephrine, vasopressin, and lipids on the restoration of cardiac function in Yorkshire pigs. After tracking the animals’ baseline vitals for 10 minutes, we injected the animals with bupropion (35 mg/kg) and initiated a randomized protocol 2 minutes after cardiac arrest. Results: Results demonstrated that animal survival given treatment combinations including epinephrine were statistically superior to any other group (p < 0.001, Fishers’ exact test). The odds of survival with use of epinephrine vs. other options were 22:1 (5.47, 88.43). Further, all animals receiving only lipids died. Cox survival analysis with bootstrapped parameter estimates provided evidence that the rapidity of cardiac recovery was maximized with a combination of epinephrine and lipids (p < 0.05). Conclusions: Lipids may require an additional chemical catalyst in order to be effective in cardiac recovery. Epinephrine and lipids combined shortened recovery time for surviving animals.