During cardiopulmonary resuscitation, Epi and other a agonists increase diastolic pressure and improve coronary blood flow. a agonists also help to preserve cerebral blood flow. Thus, during external cardiac massage, Epi facilitates distribution of the limited cardiac output to the cerebral and coronary circulations. The optimal dose of epinephrine in patients with cardiac arrest is unclear. Once a cardiac rhythm has been restored, it may be necessary to treat arrhythmias, hypotension, or shock. Treatment of cardiac arrhythmias is detailed in Chapter 34.
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