Resuscitation
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Randomized Controlled Trial
Fluoxetine has neuroprotective effects after cardiac arrest and cardiopulmonary resuscitation in mouse.
Fluoxetine, a selective serotonin reuptake inhibitor, is protective in a rat focal ischaemia model via anti-inflammatory mechanisms. Cardiac arrest and cardiopulmonary resuscitation (CA/CPR) were performed in mice to test the hypothesis that fluoxetine protects the brain following global cerebral ischaemia, even when administered after an insult. ⋯ Our data showed that 10mg/kg fluoxetine administered following global cerebral ischaemia decreases neuronal damage. Although long-term neuroprotection needs further study, the results of our study suggest that fluoxetine may have therapeutic potential when administered after global cerebral ischaemia, cardiac arrest and cardiopulmonary resuscitation.
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Induced mild therapeutic hypothermia (MTH) is an effective treatment to improve outcome after out-of-hospital resuscitation. Adverse events are rare, but arrhythmias and bleeding complications have been reported. So far, only few data about electrocardiographic changes and associated events have been reported. ⋯ Under strict clinical and laboratory parameter control, induced mild therapeutic hypothermia can be applied to most patients after out-of-hospital cardiac arrest with no increased risk for arrhythmias despite significant electrocardiographic changes.
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Mild therapeutic hypothermia has shown to improve long-time survival as well as favorable functional outcome after cardiac arrest. Animal models suggest that ischemic durations beyond 8 min results in progressively worse neurologic deficits. Based on these considerations, it would be obvious that cardiac arrest survivors would benefit most from mild therapeutic hypothermia if they have reached a complete circulatory standstill of more than 8 min. ⋯ The beneficial effect of mild therapeutic hypothermia increases with cumulative time of complete circulatory standstill in patients with witnessed out-of-hospital cardiac arrest.
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To study the changes of brain water diffusion and cerebral haemodynamics of cortical areas using magnetic resonance imaging (MRI) in canine models of cardiac arrest (CA) and restoration of spontaneous circulation (ROSC). The secondary study objective was to evaluate whether MRI can be used to observe haemodynamic disorders in brain microcirculation. ⋯ These data provide the evidence that early MRI can be used to observe acute haemodynamic disorders in brain microcirculation in a canine model of cardiac arrest.