Mar 28, 2017

The future is now: neuroprotection during cardiopulmonary resuscitation

Current Opinion in Critical Care
Johanna C MooreDemetris Yannopoulos

Abstract

Survival with favorable neurological function after cardiac arrest remains low. The purpose of this review is to identify recent advances that focus on neuroprotection during cardiopulmonary resuscitation (CPR). Multiple strategies have been shown to enhance neuroprotection during CPR. Brain perfusion during CPR is increased with therapies such as active compression decompression CPR and intrathoracic pressure regulation that improve cardiac preload and decrease intracranial pressure. Head Up CPR has been shown to decrease intracranial pressure thereby increasing cerebral perfusion pressure and cerebral blood flow. Sodium nitroprusside enhanced CPR increases cerebral perfusion, facilitates heat exchange, and improves neurologic survival in swine after cardiac arrest. Postconditioning has been administered during CPR in laboratory settings. Poloxamer 188, a membrane stabilizer, and ischemic postconditioning have been shown to improve cardiac and neural function after cardiac arrest in animal models. Postconditioning with inhaled gases protects the myocardium, with more evidence mounting for the potential for neural protection. Multiple promising neuroprotective therapies are being developed in animal models of cardiac arrest, an...Continue Reading

Mentioned in this Paper

Cerebral Blood Flow Imaging
Sodium Nitroprusside
Blood Pressure Regulation
Neurophysiology - Biologic Function
Brain
Neuroprotection
Myocardium
Basic Cardiac Life Support
Laboratory
Blood Flow

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