Hypothermic Resuscitation in Patients with CNS Injury Due to Cardiac Arrest . FERNE Brain Illness and Injury Course. 4 th Mediterranean Emergency Medicine Congress Sorrento, Italy September 17, 2007.
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Hypothermic Resuscitation in Patients with CNS Injury Due to Cardiac Arrest
FERNE Brain Illness and Injury Course
4th MediterraneanEmergency MedicineCongressSorrento, Italy September 17, 2007
Brian J. O’Neil, MDProfessorDepartment of Emergency MedicineWayne State University,Research Director,William Beaumont HospitalRoyal Oak, MI
Learning Objectives and Key Clinical Questions
Krause GS, Kumar K, White BC, Aust SD, Wiegenstein JG. Ischemia, resuscitation, and reperfusion: Mechanisms of tissue injury and prospects for protection. Am Heart J 1986; 111:768-80.
Trials of Neuroprotection Agents in Stroke:
Kidwell CS et al. Stroke 32(6):1349-59.
MODEL OF MOLECULAR EVENTS DURING BRAIN ISCHEMIA
AND REPERFUSION THAT LEAD TO NEURONAL DEATH
eIF4G & spectrin
& caspase 9
p = 0.033
Opioid receptor antagonists:
-opiate antagonists reverse hibernation
- myocytes and neurons
-increases ERK and bcl-2
Post-ROSC Neurologic resuscitation:
needs to improve
Silver Bullet Trials have Failed
The Future Looks Bright
Currently only proven therapy
Cheap, Easy, risk / benefit ratio is huge
JUST DO IT
6/7/2014 10:29 AM