Abstract
Currently, there is an unmet therapeutic need for the medical management of cardiac arrest, as is evident from the high mortality rate associated with this condition. These dire outcomes can be attributed to the severe nature and poor prognosis of this disorder. However, the current treatment modalities, while helping to augment survival, are limited and do not offer adequate improvements to outcomes. Treatment modalities are particularly lacking when considering the underlying pathophysiology of the metabolic phase of cardiac arrest. In this study, we explore the three phases of cardiac arrest and assess the factors related to positive clinical outcomes and survival for these events. Furthermore, we evaluate the present guidelines for resuscitation and recovery, the issues related to ischemia and tissue reperfusion, and the benefit of oxygen-delivery therapeutic methods including blood transfusion therapy and synthetic hemoglobins (HBOCs). The current therapy protocols are limited specifically by the lack of an efficient method of oxygen delivery to address the metabolic phase of cardiac arrest. In this article, we investigate the next generation of HBOCs and review their properties that make them attractive for their potential application in the treatment of cardiac arrest. These products may be a viable solution to address complications associated with ischemia, reperfusion injury, and organ damage.
Highlights
During recent decades, modern medicine has benefited from many advancements addressing common and familiar ailments, allowing for improved mortality and morbidity for a large variety of pathologies
It has been shown that survival to hospital discharge is improved for out-of-hospital cardiac arrest (OOHCA) that is witnessed by a bystander/EMS (Emergency Medical Service), in patients who received bystander cardiopulmonary resuscitation (CPR), in patients with shockable rhythms, and in patients who were able to achieve in-field return of spontaneous circulation (ROSC) [10]
There are a variety of complications that stem from the ischemia and metabolic dysfunction that arise within the myocardium, and they share a similar pathophysiology to the third phase of cardiac arrest
Summary
Modern medicine has benefited from many advancements addressing common and familiar ailments, allowing for improved mortality and morbidity for a large variety of pathologies. 750,000 IHCAs occur annually in the US, with recent meta-analyses showing a pooled survival rate of 15% with minimal change over time. This event confers significant morbidity afterwards, with an estimated 1-year survival rate of 13.4% [2,3]. This review article aims to explore cardiac arrest as a currently significant and prominent pathology that has significant mortality. This review was based on a comprehensive PubMed search of the topic of cardiac arrest, blood transfusions, and hemoglobin-based oxygen carriers. Additional details regarding this search are described in Supplementary File 1
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