• Chen-Long Wu, Shih-Bin Su, Jin-Luh Chen, Cheng-Ping Chang, and How-Ran Guo.
• Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, Taiwan.
• Resuscitation. 2012 Jan 1;83(1):119-24.

Aim Of The StudyTetramethylammonium ion (TMA) is an emerging industrial chemical and has caused mortalities in humans. The present study was conducted to evaluate the effects of subcutaneously injected TMA on heart rate (HR), mean arterial blood pressure (MAP) and arterial blood gases (ABG) and to determine whether pretreatment using mechanical ventilation (MV) or atropine could prevent the mortality caused by TMA.MethodsMale Wistar rats were anesthetized and catheterized in the femoral arterials for monitoring. We injected 25, 50, 100, and 200 μmol/kg of TMA s.c. in four groups of rats respectively and compared them to a control group. The effects of MV and atropine (1mg/kg, s.c.) pretreatment were evaluated by comparing the treatment groups with the 200 μmol/kg group. The primary outcome was survival curve, and the secondary endpoints included the changes of HR, MAP, and ABG, such as arterial pH, PaO(2), PaCO(2) and calculated HCO(3)(-).ResultsTMA decreased HR, MAP, pH, and PaO(2), increased PaCO(2) and calculated HCO(3)(-) and resulted in death of all animals in the 200 μmol/kg group by 15 min. All animals pretreated with MV survived. Although all animals receiving atropine died, the mean survival time increased by 37 min. Both MV and atropinization improved HR, MAP, and ABG.ConclusionThis rat model suggests that acute respiratory failure is responsible for the mortality caused by TMA, and therefore first aid should emphasize respiratory support. Atropinization prolonged survival time in the present study that possibly bought time for further management.Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

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