| Intra-arrest cooling with delayed reperfusion yields higher survival than earlier normothermic resuscitation in a mouse model of cardiac arrest. | |
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MedLine Citation:
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PMID: 18096292 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Therapeutic hypothermia (TH) represents an important method to attenuate post-resuscitation injury after cardiac arrest. Laboratory investigations have suggested that induction of hypothermia before return of spontaneous circulation (ROSC) may confer the greatest benefit. We hypothesized that a short delay in resuscitation to induce hypothermia before ROSC, even at the expense of more prolonged ischemia, may yield both physiological and survival advantages. METHODS: Cardiac arrest was induced in C57BL/6 mice using intravenous potassium chloride; resuscitation was attempted with CPR and fluid administration. Animals were randomized into three groups (n=15 each): a normothermic control group, in which 8 min of arrest at 37 degrees C was followed by resuscitation; an early intra-arrest hypothermia group, in which 6.5 min of 37 degrees C arrest were followed by 90s of cooling, with resuscitation attempted at 30 degrees C (8 min total ischemia); and a delayed intra-arrest hypothermia group, with 90s cooling begun after 8 min of 37 degrees C ischemia, so that animals underwent resuscitation at 9.5 min. RESULTS: Animals treated with TH demonstrated improved hemodynamic variables and survival compared to normothermic controls. This was the case even when comparing the delayed intra-arrest hypothermia group with prolonged ischemia time against normothermic controls with shorter ischemia time (7-day survival, 4/15 vs. 0/15, p<0.001). CONCLUSIONS: Short resuscitation delays to allow establishment of hypothermia before ROSC appear beneficial to both cardiac function and survival. This finding supports the concept that post-resuscitation injury processes begin immediately after ROSC, and that intra-arrest cooling may serve as a useful therapeutic approach to improve survival. |
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Authors:
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Danhong Zhao; Benjamin S Abella; David G Beiser; Jason P Alvarado; Huashan Wang; Kimm J Hamann; Terry L Vanden Hoek; Lance B Becker |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2007-12-21 |
Journal Detail:
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Title: Resuscitation Volume: 77 ISSN: 0300-9572 ISO Abbreviation: Resuscitation Publication Date: 2008 May |
Date Detail:
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Created Date: 2008-04-08 Completed Date: 2008-08-26 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: Ireland |
Other Details:
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Languages: eng Pagination: 242-9 Citation Subset: IM |
Affiliation:
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Emergency Resuscitation Center, University of Chicago Hospitals, Chicago, IL 60637, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Analysis of Variance Animals Body Temperature Cardiopulmonary Resuscitation Disease Models, Animal Female Heart Arrest / therapy* Hypothermia, Induced / methods* Mice Mice, Inbred C57BL Monitoring, Physiologic / methods Random Allocation Reperfusion Injury / prevention & control* Survival Rate |
| Grant Support | |
ID/Acronym/Agency:
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1 K23 HL 83082-01/HL/NHLBI NIH HHS; K23 HL083082-02/HL/NHLBI NIH HHS; R01-HL71734-01/HL/NHLBI NIH HHS |
| Comments/Corrections | |
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