scholarly journals Hemodynamic-Directed Cardiopulmonary Resuscitation Improves Neurologic Outcomes and Mitochondrial Function in the Heart and Brain

2019 ◽  
Vol 47 (3) ◽  
pp. e241-e249 ◽  
Author(s):  
Andrew J. Lautz ◽  
Ryan W. Morgan ◽  
Michael Karlsson ◽  
Constantine D. Mavroudis ◽  
Tiffany S. Ko ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Mitochondrial Function ◽  
Neurologic Outcomes

Water Temperature and Drowning

PEDIATRICS ◽  
1991 ◽  
Vol 87 (5) ◽  
pp. 747-747
Author(s):  
MARK A NICHTER ◽  
PERRY B. EVERETT ◽  
ALBERT SALTIEL
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Water Temperature ◽  
Effective Treatment ◽  
Cardiopulmonary Arrest ◽  
King County ◽  
Rapid Cooling ◽  
Neurologic Outcomes

To the Editor.— We read with interest the report by Quan et al.1 The authors described normal or near-normal neurologic outcomes after cardiopulmonary arrest in 8 of 38 victims. We are encouraged by these results and agree that early, effective cardiopulmonary resuscitation is the most effective treatment for pediatric submersion victims. Several additional factors, however, must be considered when interpreting the results of this study. Quan et al describe the King County, Washington climate as "temperate" and note that "submersion victims in this region did not receive the potentially beneficial rapid cooling that icy waters may provide."

scholarly journals One-Year Survival and Neurologic Outcomes After Pediatric Open-Chest Cardiopulmonary Resuscitation

2019 ◽  
Vol 107 (5) ◽  
pp. 1441-1446 ◽  
Author(s):  
Kathleen L. Meert ◽  
Ralph Delius ◽  
Beth S. Slomine ◽  
James R. Christensen ◽  
Kent Page ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Neurologic Outcomes ◽  
Open Chest ◽  
One Year

scholarly journals Impaired Cerebral Mitochondrial Oxidative Phosphorylation Function in a Rat Model of Ventricular Fibrillation and Cardiopulmonary Resuscitation

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Jun Jiang ◽  
Xiangshao Fang ◽  
Yue Fu ◽  
Wen Xu ◽  
Longyuan Jiang ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Ventricular Fibrillation ◽  
Cardiopulmonary Resuscitation ◽  
Oxidative Phosphorylation ◽  
Mitochondrial Dysfunction ◽  
Rat Model ◽  
Mitochondrial Function ◽  
High Energy ◽  
Mitochondrial Morphology ◽  
High Energy Phosphates

Postcardiac arrest brain injury significantly contributes to mortality and morbidity in patients suffering from cardiac arrest (CA). Evidence that shows that mitochondrial dysfunction appears to be a key factor in tissue damage after ischemia/reperfusion is accumulating. However, limited data are available regarding the cerebral mitochondrial dysfunction during CA and cardiopulmonary resuscitation (CPR) and its relationship to the alterations of high-energy phosphate. Here, we sought to identify alterations of mitochondrial morphology and oxidative phosphorylation function as well as high-energy phosphates during CA and CPR in a rat model of ventricular fibrillation (VF). We found that impairment of mitochondrial respiration and partial depletion of adenosine triphosphate (ATP) and phosphocreatine (PCr) developed in the cerebral cortex and hippocampus following a prolonged cardiac arrest. Optimal CPR might ameliorate the deranged phosphorus metabolism and preserve mitochondrial function. No obvious ultrastructural abnormalities of mitochondria have been found during CA. We conclude that CA causes cerebral mitochondrial dysfunction along with decay of high-energy phosphates, which would be mitigated with CPR. This study may broaden our understanding of the pathogenic processes underlying global cerebral ischemic injury and provide a potential therapeutic strategy that aimed at preserving cerebral mitochondrial function during CA.

Neurologic Outcomes After Extracorporeal Cardiopulmonary Resuscitation

ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jamie E. Podell ◽  
Eric M. Krause ◽  
Raymond Rector ◽  
Mubariz Hassan ◽  
Ashwin Reddi ◽  
...  
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Neurologic Outcomes

Abstract 17412: Current Experience and Limitations of Extracorporeal Cardiopulmonary Resuscitation for Cardiac Arrest: A Single-Center Retrospective Study

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Aditi Singhvi ◽  
Nirav Patel ◽  
Jason A Gluck
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Selection Criteria ◽  
Spontaneous Circulation ◽  
Extracorporeal Cardiopulmonary Resuscitation ◽  
Neurologic Outcomes ◽  
Time To Initiation ◽  
Central Access ◽  
Refractory Cardiac Arrest

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR) may be considered for select cardiac arrest patients for whom the suspected etiology of the arrest is potentially reversible. In adults, the survival to discharge with ECPR is reportedly 22% to 33%, with better outcomes for in-hospital arrests. Outcomes with ECPR depend on multiple factors including, location of arrest, etiology, duration and quality of CPR, time to initiation of ECMO, and post-arrest management. There is no consensus regarding patient selection or management of these patients. We report our preliminary experiences with ECPR for refractory cardiac arrest. Methods: Patients who underwent ECPR between January 2013 and May 2018 were identified. The characteristics of the arrest, CPR duration, cannulation procedure, post-arrest management, complications, survival and neurologic outcomes were retrospectively reviewed. Results: A total of 24 ECPR events were identified. The median age was 60 years. The median CPR duration and time from collapse to initiation of ECMO were 35 (IQR 25.5-68) and 68 (IQR 45.5-144.5) min, respectively. Peripheral and central access sites were employed in 19 and 5 cases, respectively. Return of spontaneous circulation was achieved in 21 patients (87.5%). PCI was performed on 4 and pulmonary embolectomy on 3 patients. Median duration of ECMO support was 84 (IQR 24-168) hours. Major complications occurred in 17 patients (70.8%). Nine patients (37.5%) were successfully weaned from ECMO and 7 (29.2%) survived to hospital discharge. All of the survivors had a favorable neurologic outcome. Conclusions: ECPR as part of a comprehensive multi-faceted approach for select patients with refractory cardiac arrest may improve outcomes. We noted an improvement in outcomes over time. This could be attributed to improved selection criteria as well as clinical management. The development of selection criteria may help identify patients most likely to benefit from the use of ECPR. This would have significant resource implications for hospitals with ECMO programs.

Evaluating the effectiveness of resuscitation with extracorporeal membrane oxygenation in a model of acute hypoxic cardiac arrest in pigs (experimental study)

2014 ◽  
Vol 5 (4) ◽  
pp. 20-26
Author(s):  
Gennadiy Grigoryevich Khubulava ◽  
Aleksey Borisovich Naumov ◽  
Sergey Pavlovich Marchenko ◽  
Vitaliy Vladimirovich Suvorov ◽  
Igor Igorevich Averkin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Circulatory Support ◽  
Cardiac Massage ◽  
Membrane Oxygenation ◽  
Neurologic Outcomes ◽  
Intergroup Comparison ◽  
Life Threatening ◽  
Switching Method

Cardiopulmonary resuscitation (CPR) with closed-chest cardiac massage was developed to maintain circulation and ventilation until life-threatening problems could be corrected or reversed. Studies on the effect of CPR have shown that about 80-95 % cases of resuscitation are fatal or severe neurological consequences and survival to discharge after CPR ranged from 6 to 22 % [2, 4, 8, 11]. Furthermore, the chances of survival decline rapidly if the resuscitation period more than 10 minute. At the same time, we know that successful neurologic outcomes are inversely associated with the time of brain hypoperfusion. Because of the low survival rate after prolonged CPR, more aggressive methods have been suggested to increase success. With the advancement of techniques, extracorporeal mechanical support has been applied in conjunction with CPR, with variable results [5, 12]. To assess the efficacy of resuscitation with extracorporeal membrane oxygenation was modeled the acute hypoxic cardiac arrest in pigs. Results of the study in the two groups demonstrate efficient switching method supporting circulatory support (ECMO) in the minutes of CPR. In the provision of an extended set of measures of cardiopulmonary resuscitation in the modeling of hypoxic cardiac arrest in animals in the group with ECMO received great survival to the end of the experiment, less expressed manifestations of acute heart failure. Intergroup comparison given the prerequisites for the development of protocols with the use of ECMO CPR, which would reduce the number of complications and death in patients undergoing cardiac surgery.

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