| delta-Opioid-induced pharmacologic myocardial hibernation during cardiopulmonary resuscitation. | |
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MedLine Citation:
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PMID: 17114982 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Cardiac arrest and cardiopulmonary resuscitation is an event of global myocardial ischemia and reperfusion, which is associated with severe postresuscitation myocardial dysfunction and fatal outcome. Evidence has demonstrated that mammalian hibernation is triggered by cyclic variation of a delta-opiate-like compound in endogenous serum, during which the myocardial metabolism is dramatically reduced and the myocardium tolerates the stress of ischemia and reperfusion without overt ischemic and reperfusion injury. Previous investigations also proved that the delta-opioid agonist elicited the cardioprotection in a model of regional ischemic intact heart or myocyte. Accordingly, we were prompted to search for an alternative intervention of pharmacologically induced myocardial hibernation that would result in rapid reductions of myocardial metabolism and therefore minimize the myocardial ischemic and reperfusion injury during cardiac arrest and cardiopulmonary resuscitation. DESIGN: Prospective, controlled laboratory study. SETTING: University-affiliated research laboratory. INTERVENTIONS: In the series of studies performed in the established rat and pig model of cardiac arrest and cardiopulmonary resuscitation, the delta-opioid receptor agonist, pentazocine, was administered during ventricular fibrillation. MEASUREMENTS AND MAIN RESULTS:: The myocardial metabolism reflected by the concentration of lactate, or myocardial tissue PCO2 and PO2, is dramatically reduced during cardiac arrest and cardiopulmonary resuscitation. These are associated with less severe postresuscitation myocardial dysfunction and longer duration of postresuscitation survival. CONCLUSIONS: delta-Opioid-induced pharmacologic myocardial hibernation is an option to minimize the myocardial ischemia and reperfusion injury during cardiac arrest and cardiopulmonary resuscitation. |
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Authors:
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Xiangshao Fang; Wanchun Tang; Shijie Sun; Max Harry Weil |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Critical care medicine Volume: 34 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-11-20 Completed Date: 2007-09-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: S486-9 Citation Subset: AIM; IM |
Affiliation:
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Weil Institute of Critical Care Medicine, Rancho Mirage, California, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cardiopulmonary Resuscitation* Heart Arrest / metabolism, physiopathology, therapy* Hibernation Myocardial Reperfusion Injury / metabolism, physiopathology, prevention & control* Myocardial Stunning / metabolism Myocardium / metabolism* Rats Receptors, Opioid, delta / agonists* Swine Ventricular Fibrillation / metabolism, physiopathology, therapy |
| Chemical | |
Reg. No./Substance:
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0/Receptors, Opioid, delta |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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