Brain resuscitation: A new era?

Abstract

Knopp R: Brain resuscitation: a new era? Ann Emerg Med 9:441-442, August 1980. brain, resuscitation; resuscitation, brain In the last five years, ti~e salvage rate for victims of out-of-hospital cardiac arrest has increased dramatically. Shaffer and Cobb 1 report an initial salvage rate of 43% for victims of prehospital ventricular fibrillation with a 25% longterm survival rate. The primary reasons for this improved salvage rate appear to be a response of bystanders or basic life support personnel to initiate cardiopulmonary resuscitation (CPR) within four minutes, followed by delivery of advanced cardiac life support by paramedic personnel within eight minutes. 2 However, as a result of our improvements in cardiac resuscitation, our deficiencies in cerebral resuscitation have become apparent. The morbidity associated with brain injury resulting from global ischemia or severe closed head injury is a growing problem. What can be done to reduce the incidence of neurologic sequelae in these survivors? During the past few years, emphasis has been placed on cerebral cardiopulmonary resuscitation (CCPR) rather than on CPR. The findings of Safar z and others seem to show that brain injury may continue even after ventilation and circulation have been reestablished in patients suffering cardiac arrest. With aggressive, immediate treatment using a variety of therapeutic