Disease relevance of Resuscitation

• Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation [1].
• OBJECTIVE: To determine if the infusion of up to 1000 mL of diaspirin cross-linked hemoglobin (DCLHb) during the initial hospital resuscitation could reduce 28-day mortality in traumatic hemorrhagic shock patients [2].
• SETTING: Twenty-nine centers in the United States. PATIENTS: A total of 463 patients with severe closed head injury and a Glasgow Coma Scale score of 8 or less after resuscitation and stabilization [3].
• We recorded age, burn size, inhalation injury, resuscitation, packed-cell volume at admission, base deficit, serum osmolarity, sepsis, inotropic support, platelet count, creatinine, and ventilator dependency [4].
• If the mechanism of PSVT is unknown and the Wolff-Parkinson-White syndrome is possible, administration of adenosine should be limited to medical facilities that have emergency resuscitation equipment [5].

Psychiatry related information on Resuscitation

• Influence of pre-CPR conditions on EMS response times in circulatory arrest. The Cerebral Resuscitation Study Group [6].
• Decision making to cease or to continue cardiopulmonary resuscitation (CPR). The Cerebral Resuscitation Study Group [7].
• "Resuscitation and the decision against": draft report of the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research [8].

High impact information on Resuscitation

• Kaplan-Meier estimates of the proportions of patients who had not died or had cardiac arrest with subsequent resuscitation five years after the diagnosis of hypertrophic cardiomyopathy were 67 percent among patients with bridging and 94 percent among those without bridging (P=0.004) [9].
• Factors that predicted survival to hospital discharge included a short interval between the arrest and arrival at the hospital, a palpable pulse on presentation, a short duration of resuscitation in the emergency department, and the administration of fewer doses of epinephrine in the emergency department [10].
• CONCLUSIONS: These results suggest that out-of-hospital cardiac arrest among children has a very poor prognosis, especially when efforts at resuscitation continue for longer than 20 minutes and require more than two doses of epinephrine [10].
• Of the 83 patients entered in the study over a 13-month period, 40 were randomly assigned to conservative treatment, which consisted of resuscitation with intravenous fluids, institution of nasogastric suction, and intravenous administration of antibiotics (cefuroxime, ampicillin, and metronidazole) and ranitidine [11].
• CONCLUSIONS--This study demonstrates that ACD CPR appears to be more effective than standard CPR in a well-defined subset of victims of out-of-hospital cardiac arrest during the critical early phases of resuscitation [12].

Chemical compound and disease context of Resuscitation

• In 25 trials on 14 successfully resuscitated animals, the arterial blood lactate concentration decreased within four minutes after resuscitation from cardiac arrest [13].
• Nimodipine after resuscitation from out-of-hospital ventricular fibrillation. A placebo-controlled, double-blind, randomized trial [14].
• A monoclonal antibody to the adherence-promoting leukocyte glycoprotein, CD18, reduces organ injury and improves survival from hemorrhagic shock and resuscitation in rabbits [15].
• BACKGROUND: Studies in animals have suggested that intravenous vasopressin is associated with better vital-organ perfusion and resuscitation rates than is epinephrine in the treatment of cardiac arrest [16].
• CONCLUSIONS: Dobutamine begun within 15 minutes of successful resuscitation can successfully overcome the global systolic and diastolic left ventricular dysfunction resulting from prolonged cardiac arrest and cardiopulmonary resuscitation [17].

Biological context of Resuscitation

• Left ventricular ejection fraction fell from a prearrest 58 +/- 3% to 25 +/- 3% at 5 hours after resuscitation in the control group but remained unchanged in the dobutamine (10 micrograms.kg-1.min-1) group (52 +/- 1% prearrest and 55 +/- 3% at 5 hours after resuscitation) [17].
• During CPR and at 2 hours after resuscitation, there were no differences between drug groups in the level of regional cerebral or coronary blood flow, cerebral O2 uptake, or evoked potentials [18].
• RESULTS: Chronic resuscitation with 5 mL/kg/hr RL, but not with 0 or 10 mL/kg/hr RL, restored cardiac output, hepatocellular function, and hepatic microvascular blood flow at 20 hours after hemorrhage [19].
• METHODS: Adult mongrel pigs underwent general anesthesia with Isoflurane and were then randomized to 1 of 3 groups: control, contamination (colon puncture with stool contamination of the pelvis), or shock + contamination (40% blood volume for 1 hour, then resuscitation with shed blood and crystalloid, plus contamination) [20].
• RESULTS: AG 556 treatment restored the depressed cardiovascular and hepatocellular functions after trauma-hemorrhage and resuscitation, which was associated with reduced phosphorylation of mitogen-activated protein kinases p44/42 and p38 [21].

Anatomical context of Resuscitation

• The present studies evaluated the effect of hypertonic resuscitation on the development of lung injury in a hemorrhagic shock model in which antecedent shock primes for increased lung neutrophil sequestration in response to intratracheal LPS [22].
• The importance of adenosine and a colloid (Dextran 40) in resuscitation of ischemically damaged canine pancreas during preservation by the two-layer method [23].
• Pentoxifylline prevention of altered hepatocyte calcium regulation during hemorrhagic shock/resuscitation [24].
• With implementation of the SOP, use of dobutamine (12/30 vs. 2/30), insulin (blood glucose <150 mg/dL, day 4: 26/28 vs. 13/25), hydrocortisone (30/30 vs. 13/30), and rhAPC (7/30 vs. 0/30) significantly increased, whereas volume for resuscitation and use of packed red blood cells were unaffected [25].
• INTERVENTIONS: Starting at 20 mins of hemorrhagic shock and continuing through the resuscitation phase, all three groups received both intraperitoneal lavage and repeated bolus injections into the ileum of vehicle (normal saline) or adenosine [26].

Associations of Resuscitation with chemical compounds

• In 24 animals in whom resuscitation efforts failed, arterial lactate concentrations increased throughout the observation period [13].
• Nimodipine may be of benefit in patients with delayed resuscitation [14].
• In addition, CT1501R treatment prevented increases in mRNA levels and protein production of a variety of proinflammatory cytokines in multiple lung cell populations after blood loss and resuscitation [27].
• The Burns Calculator is designed for use during the first eight hours post-injury and is based upon the Parkland resuscitation formula, using only Hartmann's solution BP [28].
• Intratracheal prostacyclin for resuscitation in primary pulmonary hypertension [29].

Gene context of Resuscitation

• A single dose of flutamide (25 mg/kg body weight), with or without an ER antagonist (ICI 182,780), a HO enzyme inhibitor [chromium-mesoporphyrin (CrMP)], or vehicle, was administered subcutaneously during resuscitation [30].
• At the onset of resuscitation, rats received vehicle, flutamide (25 mg/kg body wt), flutamide in combination with estrogen receptor (ER) antagonist ICI-182,780 (3 mg/kg body wt), or ICI-182,780 alone [31].
• Contribution of tumor necrosis factor-alpha to pulmonary cytokine expression and lung injury after hemorrhage and resuscitation [32].
• E2 (50 mug/kg), ER-alpha agonist propyl pyrazole triol (PPT; 5 mug/kg), ER-beta agonist diarylpropiolnitrile (DPN; 5 mug/kg), or vehicle (10% DMSO) was injected subcutaneously during resuscitation [33].
• In order to examine the role of TNF-alpha in producing acute inflammatory lung injury, we treated mice following haemorrhage and resuscitation with a TNF antagonist, composed of soluble dimeric human p80 TNF receptor linked to the Fc region of human IgG1 (sTNFR:Fc) [34].

Analytical, diagnostic and therapeutic context of Resuscitation

• METHODS: In a single-centre study, we measured arterial blood lactate early (median 4 h) and after fluid resuscitation (median 12 h) in patients admitted to a tertiary-referral intensive-care unit [35].
• When other variables have returned to normal, continued attempts at resuscitation based on elevated blood lactate may lead to unnecessary use of blood transfusion and inotropic agents in an effort to increase oxygen delivery and lactate clearance [36].
• At 5 minutes after successful resuscitation, epinephrine was 6.8 ng/mL in the control group and 16.1 ng/mL in the angiotensin II group (P < .05) [37].
• Because of the low rates of resuscitation and long-term survival in patients presenting in asystole and EMD, proving that calcium chloride does not enhance survival would require large multicenter trials [38].
• METHODS: Male C3H/HeN mice were subjected to a midline laparotomy and polyvinyl alcohol sponges were implanted subcutaneously in the abdominal wound before hemorrhage (35+/-5 mm Hg for 90 minutes and resuscitation) or sham operation [39].

References