Early neuroprotection after cardiac arrest

  title={Early neuroprotection after cardiac arrest},
  author={Antonio Maria Dell’anna and Sabino Scolletta and Katia Donadello and Fabio Silvio Taccone},
  journal={Current Opinion in Critical Care},
Purpose of reviewMany efforts have been made in the last decades to improve outcome in patients who are successfully resuscitated from sudden cardiac arrest. Despite some advances, postanoxic encephalopathy remains the most common cause of death among those patients and several investigations have focused on early neuroprotection in this setting. Recent findingsTherapeutic hypothermia is the only strategy able to provide effective neuroprotection in clinical practice. Experimental studies… 

Postcardiac arrest temperature management: infectious risks

Therapeutic hypothermia following out-of-hospital cardiac arrest improves neurological recovery and more broadly, temperature management, as a risk for ICU infection is discussed.

Pharmacologic neuroprotection in ischemic brain injury after cardiac arrest

A number of different pharmacologic agents that may have a potential role in targeting these injurious pathways following cardiac arrest are discussed.

Therapeutic hypothermia promotes cerebral blood flow recovery and brain homeostasis after resuscitation from cardiac arrest in a rat model

Early application of TH facilitates restoration of CBF back to baseline levels after CA, which in turn results in the restoration of brain electrical activity and improved neurological outcome.

Moving to human trials for argon neuroprotection in neurological injury: a narrative review.

Is Glibenclamide the New Cool in Cardiopulmonary Resuscitation?

Since the Enlightenment, CPR has been mostly about the heart, not the brain, whereas arguably the brain is the organ most vulnerable to cardiac arrest, whereas recent decades have witnessed huge advances in cardiovascular pharmacotherapy that have evolved into the life-saving treatments the authors now take as routine.

Gynostemma pentaphyllum is neuroprotective in a rat model of cardiopulmonary resuscitation

The results emphasize the importance of the early post-resuscitation phase for the neurological outcome after ACA/ Resuscitation, and demonstrated the power of GP substitution as neuroprotective intervention.

Long-term depression in Purkinje neurons is persistently impaired following cardiac arrest and cardiopulmonary resuscitation in mice

  • N. QuillinanG. Deng P. Herson
  • Biology
    Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
  • 2017
Sustained impairments in synaptic plasticity in Purkinje neurons that survive the initial injury and which likely contribute to motor coordination impairments observed after CA/CPR are demonstrated.



Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia.

Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia

This randomized, controlled trial compared the effects of moderate hypothermia and normothermia in patients who remained unconscious after resuscitation from out-of-hospital cardiac arrest to survive to hospital discharge and be discharged to home or to a rehabilitation facility.

Mild hypothermia during advanced life support: a preliminary study in out-of-hospital cardiac arrest

Prehospital induction of therapeutic hypothermia using infusion of 2 l of 4°C normal saline during advanced life support was feasible, effective and safe and Larger studies are required to assess the impact that this early cooling has on neurological outcomes after cardiac arrest.

Design of the PRINCESS trial: pre-hospital resuscitation intra-nasal cooling effectiveness survival study (PRINCESS)

This ongoing trial will assess the impact of IATH with TNEC, which may be able to rapidly induce brain cooling and have fewer side effects than other methods, such as cold fluid infusion, if this intervention is found to improve neurological outcome.

Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest.

In patients who have been successfully resuscitated after cardiac arrest due to ventricular fibrillation, therapeutic mild hypothermia increased the rate of a favorable neurologic outcome and reduced mortality.

Intra-Arrest Cooling Improves Outcomes in a Murine Cardiac Arrest Model

Timing of hypothermia is a crucial determinant of survival in the murine arrest model, and early intra-arrest cooling appears to be significantly better than delayed post-ROSC cooling or normothermic resuscitation.