A systematic review of neuroprotective strategies after cardiac arrest: From bench to bedside (part I-Protection via specific pathways)

Dustin B. Mangus, Lei Huang, Patricia Applegate, Jason W. Gatling, John Zhang, Richard Lee Applegate

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

Abstract

Neurocognitive deficits are a major source of morbidity in survivors of cardiac arrest. Treatment options that could be implemented either during cardiopulmonary resuscitation or after return of spontaneous circulation to improve these neurological deficits are limited. We conducted a literature review of treatment protocols designed to evaluate neurologic outcome and survival following cardiac arrest with associated global cerebral ischemia. The search was limited to investigational therapies that were utilized to treat global cerebral ischemia associated with cardiac arrest. In this review we discuss potential mechanisms of neurologic protection following cardiac arrest including actions of several medical gases such as xenon, argon, and nitric oxide. The 3 included mechanisms are: 1. Modulation of neuronal cell death; 2. Alteration of oxygen free radicals; and 3. Improving cerebral hemodynamics. Only a few approaches have been evaluated in limited fashion in cardiac arrest patients and results show inconclusive neuroprotective effects. Future research focusing on combined neuroprotective strategies that target multiple pathways are compelling in the setting of global brain ischemia resulting from cardiac arrest.

Original languageEnglish (US)
Article number9
JournalMedical Gas Research
Volume4
Issue number1
DOIs
StatePublished - May 1 2014
Externally publishedYes

Keywords

  • Argon
  • Cardiac arrest
  • Global brain ischemia
  • Neuronal death
  • Neuroprotection
  • Nitric oxide
  • Resuscitation
  • Xenon

ASJC Scopus subject areas

  • Neuroscience (miscellaneous)
  • Anesthesiology and Pain Medicine

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