Resuscitation research has focused primarily on the initial stage of cardiac resuscitation and options by which a viable rhythm and spontaneous circulation could be restored. Less well defined, however, is the metabolic and mechanical fate of the myocardium after cardiac arrest has been reversed. The current proposal addresses these two stages of cardiac resuscitation with special focus on pharmacological interventions. The goal is to define the rationale, indication, timing and sequencing of vasopressor/inotropic and buffer therapy and to understand their potential interactions. A sequence of experiments would be performed on an established porcine model of cardiac arrest in which resuscitation would be attempted by conventional closed-chest methods. Myocardial blood blow in conjunction with coronary arteriovenous 02, C02, and lactate gradients and direct measurement of myocardial PO2, (H+), PC02 would serve as measures of altered myocardial metabolism and especially of ischemia. Myocardial PC02 would also serve as a marker of the severity and prognosis of myocardial ischemia. Left ventricular pressure-volume measurements, utilizing the conductance method, would provide indices of myocardial contractility, relaxation and compliance.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
2R01HL039148-04A2
Application #
3355779
Study Section
Cardiovascular and Pulmonary Research A Study Section (CVA)
Project Start
1987-09-30
Project End
1994-11-30
Budget Start
1991-12-23
Budget End
1992-11-30
Support Year
4
Fiscal Year
1992
Total Cost
Indirect Cost
Name
Rosalind Franklin University
Department
Type
Schools of Medicine
DUNS #
069501252
City
North Chicago
State
IL
Country
United States
Zip Code
60064
Tang, W; Pakula, J L; Weil, M H et al. (1996) Adrenergic vasopressor agents and mechanical ventilation for the treatment of experimental septic shock. Crit Care Med 24:125-30
Gazmuri, R J; Weil, M H; Bisera, J et al. (1996) Myocardial dysfunction after successful resuscitation from cardiac arrest. Crit Care Med 24:992-1000
Noc, M; Weil, M H; Tang, W et al. (1995) Mechanical ventilation may not be essential for initial cardiopulmonary resuscitation. Chest 108:821-7
Johnson, B A; Weil, M H; Tang, W et al. (1995) Mechanisms of myocardial hypercarbic acidosis during cardiac arrest. J Appl Physiol 78:1579-84
Desai, V S; Weil, M H; Tang, W et al. (1995) Hepatic, renal, and cerebral tissue hypercarbia during sepsis and shock in rats. J Lab Clin Med 125:456-61
Fukui, M; Weil, M H; Tang, W et al. (1995) Airway protection during experimental CPR. Chest 108:1663-7
Duggal, C; Weil, M H; Tang, W et al. (1995) Effect of arrest time on the hemodynamic efficacy of precordial compression. Crit Care Med 23:1233-6
Yang, L; Weil, M H; Noc, M et al. (1994) Spontaneous gasping increases the ability to resuscitate during experimental cardiopulmonary resuscitation. Crit Care Med 22:879-83
Noc, M; Weil, M H; Gazmuri, R J et al. (1994) Ventricular fibrillation voltage as a monitor of the effectiveness of cardiopulmonary resuscitation. J Lab Clin Med 124:421-6
Tang, W; Weil, M H; Sun, S et al. (1994) Cardiopulmonary resuscitation by precordial compression but without mechanical ventilation. Am J Respir Crit Care Med 150:1709-13

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