Ischemia Reperfusion Injury as a modifiable Therapeutic TARGET FOR cardioprotection OR neuroprotection in patients undergoing CARDIOPULMONARY resuscitation

Abstract Quick restoration of blood flow is essential in patients who have cardiac arrest or other conditions associated with local or global cessation of blood flow. This restoration of flow is associated with multiple deleterious cellular changes. We sought to review these changes to try to unders...

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Bibliographic Details
Published in:Resuscitation 2016-08, Vol.105, p.85-91
Main Authors: Madathil, Ronson J, Hira, Ravi S, Stoeckl, Mathias, Sterz, Fritz, Elrod, JoAnn Broeckel, Nichol, Graham
Format: Article
Language:English
Subjects:
Apoptosis
Brain Ischemia - prevention & control
Cardiac arrest
Cardiopulmonary Resuscitation - adverse effects
Cardiopulmonary Resuscitation - methods
Conditioning
Emergency
Humans
Hypothermia, Induced - methods
Ischemic Preconditioning - methods
Ischemic Preconditioning, Myocardial
Myocardial Infarction - therapy
Myocardial Ischemia - prevention & control
Necrosis
Neuroprotection
Out-of-Hospital Cardiac Arrest - therapy
Propofol
Reperfusion injury
Reperfusion Injury - etiology
Reperfusion Injury - prevention & control
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Summary:Abstract Quick restoration of blood flow is essential in patients who have cardiac arrest or other conditions associated with local or global cessation of blood flow. This restoration of flow is associated with multiple deleterious cellular changes. We sought to review these changes to try to understand whether ischemia-reperfusion injury (RI) is a potentially modifiable therapeutic target for cardioprotection or neuroprotection in patients undergoing cardiopulmonary resuscitation. Remote ischemic conditioning (RIC) involves brief episodes of non-lethal ischemia and reperfusion applied to an organ or limb distal to the heart and brain. Induction of hypothermia involves cooling an ischemic organ or body. Both have pluripotent effects that reduce the potential harm associated with RI in the heart and brain by reduced opening of the mitochondrial permeability transition pore. Recent trials of RIC and induced hypothermia did not demonstrate these treatments to be effective. Assessment of the effect of these interventions in humans to date may have been modified by use of concurrent medications including propofol. Ongoing research is necessary to assess whether reduction of RI improves patient outcomes.
ISSN:0300-9572
1873-1570
DOI:10.1016/j.resuscitation.2016.04.009