ROLE OF POLY(ADP-RIBOSE) POLYMERASE IN LIMITING BRAIN INJURY FOLLOWING CARDIAC ARREST AND CARDIOPULMONARY RESUSCITATION

2002 ◽  
Vol 30 (Supplement) ◽  
pp. A24
Author(s):  
Richard J Traystman ◽  
Julia Kofler ◽  
Patricia D Hurn
Keyword(s):  
Cardiac Arrest ◽  
Brain Injury ◽  
Cardiopulmonary Resuscitation

Brain Injury after Cardiac Arrest and Cardiopulmonary Resuscitation: Role of PARP-1

2002 ◽  
Vol 96 (Sup 2) ◽  
pp. A759
Author(s):  
Julia Kofler ◽  
Kimihiko Hattori ◽  
Valina L. Dawson ◽  
Patricia D. Hurn ◽  
Richard J. Traystman
Keyword(s):  
Cardiac Arrest ◽  
Brain Injury ◽  
Cardiopulmonary Resuscitation ◽  
Parp 1

Abstract T P295: Neurological Recovery Following Out-of-hospital Cardiac Arrest: Role of Hypothermia

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
I-Chen Yu ◽  
Nathan Schleinkofer ◽  
Joo-Young Maeng ◽  
Yu-Chieh Chen ◽  
Riddhi Doshi ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Injury ◽  
Neurological Outcome ◽  
The United States ◽  
Neurological Function ◽  
Neuroprotective Strategies ◽  
Included Review ◽  
Initial Rhythm ◽  
Hospital Cardiac Arrest

Introduction: Every year about 70% of coronary heart disease deaths in the United States occur out of hospital, usually presenting as ‘sudden death’ due to cardiac arrest. Despite the improvement of survival with advanced cardiac interventions, mortality remains high. Therapeutic hypothermia (TH) has been shown to be neuroprotective after cardiac arrest. We explored factors associated with good recovery of neurological function following out-of-hospital cardiac arrest (OHCA). Methods: This retrospective study included review of electronic medical records from a major healthcare system in Northeast Indiana. Individuals who suffered OHCA from January 2011 to June 2014 were included. Neurological function was evaluated by Modified Rankin Scale (mRS) at discharge. The neurological outcome was defined as good (mRS 0-3), poor (mRS 4-5), and deceased (mRS 6) to assess the association of examined variables. Results: Among the 111 patients meeting inclusion criteria, the mortality at discharge was 68.6% in TH-treated patients and 84% in normothermia patients. For almost half (47.5%) of the patients undergoing TH who died prior to discharge, brain-related causes were the primary cause of death. 21 patients who had imaging or pathological examinations all showed evidences of ischemic brain injury. Among TH-treated survivors, patients with return of spontaneous cardiac rhythm (ROSC) within 20 minutes of onset were 1.4 times the odds more likely to have a good neurological outcome at discharge (p=0.02). Patients with ventricular fibrillation had 2 times the odds more likely retaining good neurological function at discharge after receiving TH treatment (p=0.012). The time to initiate TH (mean 2.3 ± 1.5 hours) and time to reach target temperature (mean 7.2 ± 2.3 hours) were not associated with neurological outcome at discharge. Conclusions: Initial rhythm and time to ROSC were identified as reliable predictors of good neurological function following OHCA. TH has been found to be insufficient in preventing brain injury. This study emphasizes the need for future studies to develop new neuroprotective strategies to improve survival among OHCA patients.

scholarly journals Beneficial Effects of Nitric Oxide on Outcomes after Cardiac Arrest and Cardiopulmonary Resuscitation in Hypothermia-treated Mice

2014 ◽  
Vol 120 (4) ◽  
pp. 880-889 ◽  
Author(s):  
Kotaro Kida ◽  
Kazuhiro Shirozu ◽  
Binglan Yu ◽  
Joseph B. Mandeville ◽  
Kenneth D. Bloch ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Cardiac Arrest ◽  
Cerebral Blood Flow ◽  
Brain Injury ◽  
Cardiopulmonary Resuscitation ◽  
Inhaled Nitric Oxide ◽  
Wild Type ◽  
Beneficial Effects ◽  
Endogenous Nitric Oxide

Abstract Background: Therapeutic hypothermia (TH) improves neurological outcomes after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). Although nitric oxide prevents organ injury induced by ischemia and reperfusion, role of nitric oxide during TH after CPR remains unclear. In this article, the authors examined the impact of endogenous nitric oxide synthesis on the beneficial effects of hypothermia after CA/CPR. The authors also examined whether or not inhaled nitric oxide during hypothermia further improves outcomes after CA/CPR in mice treated with TH. Methods: Wild-type mice and mice deficient for nitric oxide synthase 3 (NOS3−/−) were subjected to CA at 37°C and then resuscitated with chest compression. Body temperature was maintained at 37°C (normothermia) or reduced to 33°C (TH) for 24 h after resuscitation. Mice breathed air or air mixed with nitric oxide at 10, 20, 40, 60, or 80 ppm during hypothermia. To evaluate brain injury and cerebral blood flow, magnetic resonance imaging was performed in wild-type mice after CA/CPR. Results: Hypothermia up-regulated the NOS3-dependent signaling in the brain (n = 6 to 7). Deficiency of NOS3 abolished the beneficial effects of hypothermia after CA/CPR (n = 5 to 6). Breathing nitric oxide at 40 ppm improved survival rate in hypothermia-treated NOS3−/− mice (n = 6) after CA/CPR compared with NOS3−/− mice that were treated with hypothermia alone (n = 6; P < 0.05). Breathing nitric oxide at 40 (n = 9) or 60 (n = 9) ppm markedly improved survival rates in TH-treated wild-type mice (n = 51) (both P < 0.05 vs. TH-treated wild-type mice). Inhaled nitric oxide during TH (n = 7) prevented brain injury compared with TH alone (n = 7) without affecting cerebral blood flow after CA/CPR (n = 6). Conclusions: NOS3 is required for the beneficial effects of TH. Inhaled nitric oxide during TH remains beneficial and further improves outcomes after CA/CPR. Nitric oxide breathing exerts protective effects after CA/CPR even when TH is ineffective due to impaired endogenous nitric oxide production.

scholarly journals Role of blood gas analysis during cardiopulmonary resuscitation in out-of-hospital cardiac arrest patients

Medicine ◽  
2016 ◽  
Vol 95 (25) ◽  
pp. e3960 ◽  
Author(s):  
Youn-Jung Kim ◽  
You Jin Lee ◽  
Seung Mok Ryoo ◽  
Chang Hwan Sohn ◽  
Shin Ahn ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Hospital Cardiac Arrest

HMGB1 binding heptamer peptide improves survival and ameliorates brain injury in rats after cardiac arrest and cardiopulmonary resuscitation

Neuroscience ◽  
2017 ◽  
Vol 360 ◽  
pp. 128-138 ◽  
Author(s):  
Xue Shi ◽  
Miaodan Li ◽  
Kaibin Huang ◽  
Shiming Zhou ◽  
Yafang Hu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Injury ◽  
Cardiopulmonary Resuscitation

scholarly journals Role of ultrasound in cardiopulmonary resuscitation: Ultrasound CPR

2021 ◽  
Vol 43 (1-2) ◽  
pp. 31-39
Author(s):  
Isidora Jovanović ◽  
Sanja Ratković ◽  
Adi Hadžibegović ◽  
Tijana Todorčević ◽  
Snežana Komnenović ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Spontaneous Circulation ◽  
Return Of Spontaneous Circulation ◽  
Repeat Test ◽  
Echocardiographic Evaluation ◽  
Focused Echocardiography ◽  
Short Time

Ultrasound has predictive value of identification and management of reversible causes of cardiac arrest on the outcome after applied CPR, in terms of ROSC (return of spontaneous circulation) and the hospital discharge and neurological findings after applied CPR measures. Ultrasound is used in all phases of resuscitation including period before cardiac arrest, during cardiopulmonary resuscitation (CPR), and in the period after that. Ultrasound use during CPR offers numerous advantages including non-invasiveness, easiness, the short time for examination and a safe possibility for a repeat test whenever it is needed. Focused Echocardiography Examination in Life support (FEEL) and Focused Echocardiographic Evaluation in Resuscitation (FEER) protocols are mostly used when we talk about heart examination in cardiopulmonary resuscitation.

scholarly journals Cardiopulmonary Resuscitation: Recent Advances

2020 ◽  
Author(s):  
Abhishek Kumar ◽  
Pratishtha Yadav ◽  
Rakesh Garg
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Time Management ◽  
Life Support ◽  
Point Of Care ◽  
Spontaneous Circulation ◽  
Current Evidence ◽  
Recent Advances ◽  
Cpr Training

Cardiac arrest is the most significant reason for mortality and morbidities worldwide. With a better understanding of the pathophysiology of cardiac arrest, simple adaptations in basic life support to upcoming modifications in post-resuscitation care have been proposed by various resuscitation councils throughout the globe. Role of point of care cardiac ultrasound during cardiopulmonary resuscitation (CPR) has been explored and its contribution for identifying reversible causes and its real time management has been explored. A higher blood and tissue oxygenation levels contributed to an increased rate of return of spontaneous circulation (ROSC) which has to lead us to explore more options to increase the oxygenation. Starting from the CPR training, the use of sensors for spirometric feedback in ventilation maneuvers can help improve the quality of CPR. High flow nasal oxygenation during CPR has shown promising results. Extracorporeal CPR is another entity that has shown survival benefits in a selected group of patients. The aim of the newer advances has always been to decrease the morbidity and improve survival outcomes in terms of neurological deficit as well. These guidelines are reviewed and updated regularly to improve knowledge and training based on the current evidence. This chapter shall focus on recent advances in cardiopulmonary resuscitation.

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