Resuscitation from clinical death: Pathophysiologic limits and therapeutic potentials

  title={Resuscitation from clinical death: Pathophysiologic limits and therapeutic potentials},
  author={Peter J Safar},
  journal={Critical Care Medicine},
  • P. Safar
  • Published 1988
  • Medicine
  • Critical Care Medicine
Modern cardiopulmonary-cerebral resuscitation (CPCR) for the reversal of clinical death (i.e., prolonged cardiac arrest) is a sequence of basic, advanced and prolonged life-support steps. This system was initiated by research that started in the 1950s. Present community-wide results are encouraging, but suboptimal. Maximal benefit from CPCR will be achievable: a) by minimizing response times; and b) by extending reversible arrest times—the topic of this symposium. For reperfusion, closed chest… Expand
Cerebral resuscitation after cardiac arrest: research initiatives and future directions.
  • P. Safar
  • Medicine
  • Annals of emergency medicine
  • 1993
The numbers of conscious survivors have been increased with more effective reperfusion by open-chest CPR or emergency cardiopulmonary bypass, an early hypertensive bout, early post-arrest calcium entry blocker therapy, or mild cerebral hypothermia immediately following cardiac arrest. Expand
Systematic development of cerebral resuscitation after cardiac arrest. Three promising treatments: cardiopulmonary bypass, hypertensive hemodilution, and mild hypothermia.
It is hypothesize that post-arrest perfusion failure and necrotizing cascades require etiology-specific combination treatments that are not currently available in the literature. Expand
Cerebral resuscitation potentials for cardiac arrest.
Research since the 1980s in dog outcome models of prolonged exsanguination cardiac arrest has culminated in brain and organism preservation during cardiac arrest (no-flow) durations of up to 90 mins at a tympanic temperature of 10 degrees C and complete recovery of function and normal histology. Expand
Emergency cardiopulmonary bypass for resuscitation from prolonged cardiac arrest.
Emergency closed-chest cardiopulmonary bypass by veno-arterial pumping via oxygenator is presented in this review as a potential addition to ALS-PLS for selected cases and enhanced survival and neurological recovery over those achieved with CPR-ALS attempts only. Expand
Part 7.5: Postresuscitation Support
Initial stabilization and temperature/metabolic factors that may be relevant to improving postresuscitation outcome, particularly in the critically ill survivor are discussed. Expand
External cardiopulmonary resuscitation preserves brain viability after prolonged cardiac arrest in dogs.
A dog model was used with ventricular fibrillation of 20 minutes, reperfusion with brief cardiopulmonary bypass, controlled ventilation to 20 hours, and intensive care to 96 hours and six of 10 dogs achieved normality in group I, as compared with none of 10 in group II. Expand
Early Cooling in Cardiac Arrest: What is the Evidence?
Prolonged therapeutic hypothermia is the only post-resuscitation therapy clinically demonstrated to improve the outcome of cardiac arrest survivors and is recommended by the International Liaison Committee on Resuscitation (ILCOR). Expand
Cerebral resuscitation from cardiac arrest: pathophysiologic mechanisms.
Both the period of total circulatory arrest to the brain and postischemic-anoxic encephalopathy (cerebral postresuscitation syndrome or disease), after normothermic cardiac arrests of between 5 andExpand
CardiopulmonaryResuscitation : From theBeginning to thePresent Day
Cardiac arrest represents a dramatic event that can occur suddenly and often without premonitory signs, characterized by sudden loss of consciousness and breathing after cardiac output ceases andExpand
Future directions for resuscitation research. II. External cardiopulmonary resuscitation basic life support.
Although airway control and direct mouth-to-mouth ventilation skills are difficult to acquire, they must continue to be taught to the lay public and health professionals, primarily for use on relatives and friends where infection risk is not a problem. Expand