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A Comparison of Distilled Water and Normal Saline as Diluents for Endobronchial Administration of Epinephrine in the Dog

We compared the effects of distilled water and normal saline as diluents for the endobronchial administration of epinephrine in anesthetized dogs by using a cross-over design. Six dogs received 2 mL of either normal saline or distilled water into the bronchus, and the other solution was administered 1 wk later. Eight dogs received 0.02 mg/kg epinephrine diluted in either distilled water (E + water) or normal saline (E + saline) to a total volume of 2 mL into the bronchus, and the other solution was administered 1 wk later. Normal saline or distilled water without epinephrine did not affect the plasma epinephrine concentration, mean arterial pressure (MAP), and Pao2. The peak plasma epinephrine concentration was significantly larger after treatment with E + water (26.5 ± 7.9 ng/mL) than after E + saline (2.1 ± 0.7 ng/mL). E + water caused an increase in MAP of 91 ± 24 mm Hg, whereas E + saline did not affect MAP. The maximal decrease in Pao2 after the administration of E + water (14 ± 5 mm Hg) was significantly greater than after E + saline (7 ± 2 mm Hg). In conclusion, distilled water as the diluent for endobronchially administered epinephrine to a total volume of 2 mL allowed better absorption of epinephrine compared with normal saline without a serious detrimental effect on Pao2. Implications Using a small volume of distilled water as the diluent for endobronchial epinephrine administration significantly increased epinephrine absorption and arterial pressure in comparison with normal saline, without having a serious detrimental effect on Pao2, in an anesthetized, noncardiopulmonary, resuscitation dog model.