Bratislava Medical Journal Vol.115, No.5, p.275-279, 2014

Background: Recent reports demostrated that levosimendan improved post-resuscitation myocardial function in rat and pig models.
Materials and methods: Rabbits were randomized into 4 groups as 12 rabbits in each group. Bupivacaine 10 mg/kg was injected as an intravenous bolus to all groups. Basic life support was performed by mechanical ventilation and manual external chest compressions. After 1 min, animals in the group 1 received 1.5 ml/ kg saline 0.9 % solution, and animals in the groups 2 and 4 received 5 ml/kg 20 % lipid emulsion for 1 min through the ear vein followed by continuous infusion at 0.25 ml/kg/min. Three additional boluses of 1.5 ml/ kg lipid emulsion were repeated at 5-min intervals. The group 3 received fluid resuscitation plus levosimendan (3 µg/kg/min) 1 min after asystole and the group 4 received both levosimendan and lipid emulsion treatment. Return of spontaneous circulation and hemodynamic metrics were obtained in 20 minutes.
Results: The number of rabbits that survived after cardiac resuscitation was lower in the Groups 1 (0 %) and 3 (33.3 %) than in the Group 4 (91.7 %) with a statistically significant difference (p < 0.001).

The number of rabbits that survived resuscitation was higher in the Group 4 than in the Group 2 (66.7 %), though not with a statistically significant difference (p = 0.317). The median duration of cardiac arrest in the Group 4 was significantly shorter than that in the other three groups (p < 0.001).
Conclusions: In this rabbit model of bupivacaine-induced cardiac arrest, resuscitation with combined iv lipid emulsion and levosimendan was more efficacious than lipid alone (Tab. 3, Ref. 24).