Document Detail

Effects of repetitive electrical shocks on postresuscitation myocardial function.
MedLine Citation:
PMID:  11098954     Owner:  NLM     Status:  MEDLINE    
Whereas myocardial cell injury can occur during electrical defibrillation proportional to the energy level of individual shocks, only minimal (or no) injury seems to develop when the energy is limited to the levels typically required to terminate ventricular fibrillation. During cardiac arrest, however, multiple shocks are often required to terminate ventricular fibrillation or to treat episodes that appear subsequently during the resuscitation effort or the postresuscitation interval. Concern exists because an inverse relationship has been reported between the number of electrical shocks delivered during cardiac resuscitation and both resuscitability and survival. Repetitive electrical shocks can alter diastolic function and prompt leftward shifts of the end-diastolic pressure-volume curves. Repetitive shocks may, therefore, contribute to the recently recognized phenomenon of postresuscitation myocardial dysfunction and hamper efforts to reestablish competent myocardial function after resuscitation. Thus, strategies aimed at limiting the number of electrical shocks during cardiopulmonary resuscitation are highly desirable. These may include real-time ventricular fibrillation waveform analysis to improve targeting of individual shocks and efforts (using mechanical and pharmacologic means) to render the myocardium more responsive to individual shocks and to promote greater electrical stability after successful defibrillation.
R J Gazmuri
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Review    
Journal Detail:
Title:  Critical care medicine     Volume:  28     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-01     Completed Date:  2000-12-14     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  N228-32     Citation Subset:  AIM; IM    
Medical Service, Section of Critical Care Medicine, North Chicago Veterans Affairs Medical Center, Illinois 60064, USA.
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MeSH Terms
Cardiomyopathies / etiology*,  physiopathology,  prevention & control
Electric Countershock / adverse effects*,  methods*
Heart Arrest / complications,  mortality,  therapy*
Survival Rate
Ventricular Dysfunction / etiology*,  physiopathology,  prevention & control

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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