Post-cardiac arrest brain injury: Pathophysiology and treatment

Journal of the Neurological Sciences

Volumn 315, Issue 1-2, 2012, Pages 1-8

  Chalkias, Athanasios ^a   Xanthos, Theodoros ^a  

^a UNIVERSITY OF ATHENS MEDICAL SCHOOL   (Greece)

Author keywords

Brain injury; Cardiac arrest; Neuroprotection; Pathophysiology; Post resuscitation period; Treatment

Indexed keywords

4 AMINOBUTYRIC ACID RECEPTOR STIMULATING AGENT; BARBITURIC ACID DERIVATIVE; CLONAZEPAM; DIAZEPAM; DICHLOROACETIC ACID; ERYTHROPOIETIN; GLUCOCORTICOID; GLUCOSE; HYPERTENSIVE AGENT; IMMUNOSUPPRESSIVE AGENT; INOTROPIC AGENT; MAGNESIUM SULFATE; N METHYL DEXTRO ASPARTIC ACID RECEPTOR BLOCKING AGENT; NEUROMUSCULAR BLOCKING AGENT; PHENYTOIN; PROPOFOL; PROTEINASE INHIBITOR; REACTIVE OXYGEN METABOLITE; THIOCTIC ACID; THIOPENTAL; UBIDECARENONE; VALPROIC ACID;

BLEEDING DISORDER; BLOOD GLUCOSE MONITORING; BRAIN INJURY; ELECTROLYTE DISTURBANCE; GLUCOSE BLOOD LEVEL; HEART ARREST; HEART ARRHYTHMIA; HEMODYNAMIC MONITORING; HUMAN; HYPERGLYCEMIA; INDUCED HYPOTHERMIA; INSULIN SENSITIVITY; LIPID PEROXIDATION; MYOCLONUS; NEUROPROTECTION; NONHUMAN; OXIDATIVE STRESS; OXYGEN THERAPY; POST CARDIAC ARREST BRAIN INJURY; PRIORITY JOURNAL; RESUSCITATION; REVIEW; SEIZURE; SHIVERING;

ANIMALS; BRAIN INJURIES; HEART ARREST; HUMANS; HYPOTHERMIA, INDUCED; NEUROPROTECTIVE AGENTS; RESUSCITATION; TREATMENT OUTCOME;

EID: 84857992858     PISSN: 0022510X     EISSN: 18785883     Source Type: Journal    
DOI: 10.1016/j.jns.2011.12.007     Document Type: Review

References (77)

1. Xu K, Puchowicz MA, Sun X, LaManna JC. Decreased brainstem function following cardiac arrest and resuscitation in aged rat. Brain Res 2010;1328:181-9.
2. Deakin CD, Nolan JP, Soar J, Sunde K, Koster RW, Smith GB, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 4. Adult advanced life support. Resuscitation 2010;81:1305-52.
3. Nolan JP, Neumar RW, Adrie C, Aibiki M, Berg RA, Böttiger BW, et al. Post-cardiac arrest syndrome: Epidemiology, pathophysiology, treatment, and prognostication A Scientific Statement from the International Liaison Committee on Resuscitation; the American Heart Association Emergency Cardiovascular Care Committee; the Council on Cardiovascular Surgery and Anesthesia; the Council on Cardiopulmonary, Perioperative, and Critical Care; the Council on Clinical Cardiology; the Council on Stroke. Resuscitation 2008;79:350-79.
4. Laver S, Farrow C, Turner D, Nolan J. Mode of death after admission to an intensive care unit following cardiac arrest. Intensive Care Med 2004;30:2126-8. (Pubitemid 40022332)
5. Chalkias A, Xanthos T. Pathophysiology and pathogenesis of post-resuscitation myocardial stunning. Heart Fail Rev 2012;17:117-28.
6. Lindner KH, Haak T, Keller A, Bothner U, Lurie KG. Release of endogenous vasopressors during and after cardiopulmonary resuscitation. Heart 1996;75:145-50. (Pubitemid 26068691)
7. El-Menyar AA. The resuscitation outcome: revisit the story of the stony heart. Chest 2005;128:2835-46. (Pubitemid 41507647)
8. Niemann JT, Garner D, Lewis RJ. Tumor necrosis factor-[alpha] is associated with early postresuscitation myocardial dysfunction. Crit Care Med 2004;32:1753-8. (Pubitemid 39050528)
9. Stahl GL, Reenstra WR, Frendl G. Complement-mediated loss of endothelium-dependent relaxation of porcine coronary arteries. Role of the terminal membrane attack complex. Circ Res 1995;76:575-83.
10. Sharma HS, Miclescu A, Wiklund L. Cardiac arrest-induced regional blood-brain barrier breakdown, edema formation and brain pathology: a light and electron microscopic study on a new model for neurodegeneration and neuroprotection in porcine brain. J Neural Transm 2011;118:87-114.
11. Muresanu DF, Sharma A, Sharma HS. Diabetes aggravates heat stress-induced blood-brain barrier breakdown, reduction in cerebral blood flow, edema formation, and brain pathology: possible neuroprotection with growth hormone. Ann N Y Acad Sci 2010;1199:15-26.
12. Sharma AB, Sun J, Howard LL,Williams Jr AG, Mallet RT. Oxidative stress reversibly inactivates myocardial enzymes during cardiac arrest. Am J Physiol Heart Circ Physiol 2007;292:H198-206. (Pubitemid 46105179)
13. De Vries HE, Kuiper J, de Boer AG, Van Berkel TJ, Breimer DD. The blood-brain barrier in neuroinflammatory diseases. Pharmacol Rev 1997;49:143-55. (Pubitemid 27291032)
14. Castejón OJ. The extracellular space in the edematous human cerebral cortex: an electron microscopic study using cortical biopsies. Ultrastruct Pathol 2009;33: 102-11.
15. Hirano A, Kawanami T, Llena JF. Electron microscopy of the blood-brain barrier in disease. Microsc Res Tech 1994;27:543-56. (Pubitemid 24111781)
16. Friberg H, Wieloch T. Mitochondrial permeability transition in acute neurodegeneration. Biochimie 2002;84:241-50.
17. Rubertsson S, Grenvik A, Wiklund L. Blood flow and perfusion pressure during open-chest versus closed-chest cardiopulmonary resuscitation in pigs. Crit Care Med 1995;23:715-25.
18. Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, Deakin C, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation 2010;81:1219-76.
19. Gazmuri RJ, Becker J. Cardiac resuscitation: the search for hemodynamically more effective methods. Chest 1997;111:712-23. (Pubitemid 27132951)
20. Ristagno G, Tang W, Huang L, Fymat A, Chang YT, Sun S, et al. Epinephrine reduces cerebral perfusion during cardiopulmonary resuscitation. Crit Care Med 2009;37: 1408-15.
21. Heyndrickx GR. Early reperfusion phenomena. Semin Cardiothorac Vasc Anesth 2006;10:236-41. (Pubitemid 44221894)
22. Lefer AM, Lefer DJ. The role of nitric oxide and cell adhesion molecules on the microcirculation in ischaemia-reperfusion. Cardiovasc Res 1996;32:743-51. (Pubitemid 26332313)
23. Goldhaber JI, Qayyum MS. Oxygen free radicals and excitation-contraction coupling. Antioxid Redox Signal 2000;2:55-64. (Pubitemid 30202454)
24. Huet O, Dupic L, Batteux F, Matar C, Chereau C, Lemiale V, et al. Postresuscitation syndrome: potential role of hydroxyl radical-induced endothelial cell damage. Crit Care Med 2011;39:1712-20.
25. Tang M, Alexander H, Clark RSB, Kochanek PM, Kagan VE, Bayr H. Minocycline reduces neuronal death and attenuates microglial response after pediatric asphyxial cardiac arrest. J Cereb Blood Flow Metab 2010;30:119-29.
26. Sims NR. Calcium, energy metabolism and the development of selective neuronal loss following shortterm cerebral ischemia. Metab Brain Dis 1995;10:191-217.
27. Martin M, Rosenthal RE, Fiskum G. Pyruvate dehydrogenase complex: metabolic link to ischemic brain injury and target of oxidative stress. J Neurosci Res 2005;79: 240-7. (Pubitemid 40116441)
28. Fiskum G, Danilov CA, Mehrabian Z, Bambrick LL, Kristian T, McKenna MC, et al. Postischemic oxidative stress promotes mitochondrial metabolic failure in neurons and astrocytes. Ann N Y Acad Sci 2008;1147:129-38.
29. Feng ZC, Sick TJ, Rosenthal M. Oxygen sensitivity of mitochondrial redox status and evoked potential recovery early during reperfusion in post-ischemic rat brain. Resuscitation 1998;37:33-41. (Pubitemid 28279438)
30. Laurent I, Monchi M, Chiche JD, Joly LM, Spaulding C, Bourgeois B, et al. Reversible myocardial dysfunction in survivors of out-of-hospital cardiac arrest. J Am Coll Cardiol 2002;40:2110-6. (Pubitemid 36005895)
31. Beck T, Goller HJ, Wree A. Chronic depression of glucose metabolism in postischemic rat brains. Stroke 1995;26:1107-13.
32. Hossmann KA. Reperfusion of the brain after global ischemia-hemodynamic disturbances. Shock 1997;8:95-101.
33. Koster RW, Baubin MA, Bossaert LL, Caballero A, Cassan P, Castrén M, et al. European Resuscitation Council Guidelines for Resuscitation 2010 Section 2. Adult basic life support and use of automated external defibrillators. Resuscitation 2010;81:1277-92.
34. Zwemer CF, Whitesall SE, D'Alecy LG. Cardiopulmonary-cerebral resuscitation with 100% oxygen exacerbates neurological dysfunction following nine minutes of normothermic cardiac arrest in dogs. Resuscitation 1994;27:159-70. (Pubitemid 24100649)
35. Mickel HS, Vaishnav YN, Kempski O, von Lubitz D, Weiss JF, Feuerstein G. Breathing 100% oxygen after global brain ischemia in Mongolian gerbils results in increased lipid peroxidation and increased mortality. Stroke 1987;18:426-30. (Pubitemid 17059670)
36. Lipinski CA, Hicks SD, Callaway CW. Normoxic ventilation during resuscitation and outcome from asphyxial cardiac arrest in rats. Resuscitation 1999;42:221-9.
37. Nolan JP, Soar J. Postresuscitation care: entering a new era. Curr Opin Crit Care 2010;16:216-22.
38. Gunn AJ, Thoresen M. Hypothermic neuroprotection. NeuroRx 2006;3:154-69. (Pubitemid 44081769)
39. Froehler MT, Geocadin RG. Hypothermia for neuroprotection after cardiac arrest: mechanisms, clinical trials and patient care. J Neurol Sci 2007;261:118-26. (Pubitemid 47313504)
40. The Hypothermia After Cardiac Arrest (HACA) Study Investigators. Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549-56.
41. Bernard SA, Jones BM, Horne MK. Clinical trial of induced hypothermia in comatose survivors of out-of-hospital cardiac arrest. Ann Emerg Med 1997;30:146-53. (Pubitemid 27334896)
42. Busch M, Soreide E, Lossius HM, Lexow K, Dickstein K. Rapid implementation of therapeutic hypothermia in comatose out-of-hospital cardiac arrest survivors. Acta Anaesthesiol Scand 2006;50:1277-83. (Pubitemid 44624310)
43. Oddo M, Schaller MD, Feihl F, Ribordy V, Liaudet L. From evidence to clinical practice: effective implementation of therapeutic hypothermia to improve patient outcome after cardiac arrest. Crit Care Med 2006;34:1865-73. (Pubitemid 43982461)
44. Don CW, Longstreth Jr WT, Maynard C, Olsufka M, Nichol G, Ray T, et al. Active surface cooling protocol to induce mild therapeutic hypothermia after out-of-hospital cardiac arrest: a retrospective before-and-after comparison in a single hospital. Crit Care Med 2009;37:3062-9.
45. Bernard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557-63. (Pubitemid 34438816)
46. Bro-Jeppesen J, Kjaergaard J, Horsted TI, Wanscher MC, Nielsen SL, Rasmussen LS, et al. The impact of therapeutic hypothermia on neurological function and quality of life after cardiac arrest. Resuscitation 2009;80:171-6.
47. Holzer M, Müllner M, Sterz F, Robak O, Kliegel A, Losert H, et al. Efficacy and safety of endovascular cooling after cardiac arrest: cohort study and Bayesian approach. Stroke 2006;37:1792-7. (Pubitemid 44297731)
48. Storm C, Steffen I, Schefold JC, Krueger A, Oppert M, Jörres A, et al. Mild therapeutic hypothermia shortens intensive care unit stay of survivors after out-of-hospital cardiac arrest compared to historical controls. Crit Care 2008;12:R78.
49. Arrich J. Clinical application of mild therapeutic hypothermia after cardiac arrest. Crit Care Med 2007:1041-7. (Pubitemid 46598953)
50. Bernard SA, Smith K, Cameron P, Masci K, Taylor DM, Cooper DJ, et al. Induction of therapeutic hypothermia by paramedics after resuscitation from out-of-hospital ventricular fibrillation cardiac arrest: a randomized controlled trial. Circulation 2010;122:737-42.
51. Oksanen T, Skrifvars MB, Varpula T, Kuitunen A, Pettilä V, Nurmi J, et al. Strict versus moderate glucose control after resuscitation from ventricular fibrillation. Intensive Care Med 2007;33:2093-100. (Pubitemid 350164573)
52. Polderman KH, Herold I. Therapeutic hypothermia and controlled normothermia in the intensive care unit: practical considerations, side effects, and cooling methods. Crit Care Med 2009;37:1101-20.
53. NICE-SUGAR Study Investigators, Finfer S, Chittock DR, Su SY, Blair D, Foster D, et al. Intensive versus conventional glucose control in critically ill patients. N Eng J Med 2009;360:1283-97.
54. Preiser JC, Devos P, Ruiz-Santana S, Mélot C, Annane D, Groeneveld J, et al. A prospective randomised multicentre controlled trial on tight glucose control by intensive insulin therapy in adult intensive care units: the Glucontrol study. Intensive Care Med 2009;35:1738-48.
55. Griesdale DE, de Souza RJ, van Dam RM, Heyland DK, Cook DJ, Malhotra A, et al. Intensive insulin therapy and mortality among critically ill patients: a meta-analysis including NICE-SUGAR study data. CMAJ 2009;180:821-7.
56. Wiener RS, Wiener DC, Larson RJ. Benefits and risks of tight glucose control in critically ill adults: a meta-analysis. JAMA 2008;300:933-44.
57. Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M, et al. Part 9: Post Cardiac Arrest Care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010;122:S768-86.
58. Longstreth Jr WT, Fahrenbruch CE, Olsufka M, Walsh TR, Copass MK, Cobb LA. Randomized clinical trial of magnesium, diazepam, or both after out-of-hospital cardiac arrest. Neurology 2002;59:506-14. (Pubitemid 34919982)
59. Randomized clinical study of thiopental loading in comatose survivors of cardiac arrest. Brain Resuscitation Clinical Trial I Study Group. N Engl J Med 1986;314:397-403.
60. Vasileiou I, Xanthos T, Koudouna E, Perrea D, Klonaris C, Katsargyris A, et al. Propofol: a review of its non-anaesthetic effects. Eur J Pharmacol 2009;605:1-8.
61. Ingvar M. Cerebral blood flow and metabolic rate during seizures. Relationship to epileptic brain damage. Ann NY Acad Sci 1986;462:194-206. (Pubitemid 16063939)
62. Hossmann KA, Oschlies U, Schwindt W, KrepH. Electronmicroscopic investigation of rat brain after brief cardiac arrest. Acta Neuropathol (Berl) 2001;101:101-13. (Pubitemid 32124481)
63. Xanthos T, Vasileiou PVS, Kakavas S, Syggelou A, Lacovidou N. The potential role of erythropoietin as a pleiotropic agent in post-cardiac arrest syndrome. Curr Pharm Des 2011;17:1517-29.
64. Brines ML, Ghezzi P, Keenan S, Agnello D, de Lanerolle NC, Cerami C, et al. Erythropoietin crosses the blood-brain barrier to protect against experimental brain injury. Proc Natl Acad Sci U S A 2000;97:10526-31.
65. Maiese K, Li F, Chong ZZ. Erythropoietin in the brain: can the promise to protect be fulfilled? Trends Pharmacol Sci 2004;25:577-83. (Pubitemid 39371148)
66. Springborg JB, Ma X, Rochat P, Knudsen GM, Amtorp O, Paulson OB, et al. A single subcutaneous bolus of erythropoietin normalizes cerebral blood flow autoregulation after subarachnoid haemorrhage in rats. Br J Pharmacol 2002;135:823-9. (Pubitemid 34177660)
67. Kawata M, Takamoto S, Kitahori K, Tsukihara H, Morota T, Ono M, et al. Erythropoietin protects the central nervous system during prolonged hypothermic circulatory arrest: an experimental study in a canine model. J Thorac Cardiovasc Surg 2006;131:1331-7. (Pubitemid 43776048)
68. Assandri R, Egger M, Gassmann M, Niggli E, Bauer C, Forster I, et al. Erythropoietin modulates intracellular calcium in a human neuroblastoma cell line. J Physiol 1999;516:343-52. (Pubitemid 29204440)
69. Eimerl S, Schramm M. The quantity of calcium that appears to induce neuronal death. J Neurochem 1994;62:1223-6. (Pubitemid 24064539)
70. Maiese K, Chong ZZ, Shang YC. Raves and risks for erythropoietin. Cytokine Growth Factor Rev 2008;19:145-55.
71. Chakraborty M, Ghosal J, Biswas T, Datta AG. Effect of erythropoietin on membrane lipid-peroxidation, superoxide-dismutase, catalase, and glutathione-peroxidase of rat Rbc. Biochem Med Metab Biol 1998;40:8-18.
72. Chong ZZ, Kang JQ, Maiese K. Hematopoietic factor erythropoietin fosters neuroprotection through novel signal transduction cascades. J Cereb Blood Flow Metab 2002;22:503-14. (Pubitemid 34477771)
73. Digicaylioglu M, Lipton SA. Erythropoietin-mediated neuroprotection involves cross-talk between Jak2 and NF-kB signaling cascades. Nature 2001;412:641-7. (Pubitemid 32772276)
74. Villa P, Bigini P, Mennini T, Agnello D, Laragione T, Cagnotto A, et al. Erythropoietin selectively attenuates cytokine production and inflammation in cerebral ischemia by targeting neuronal apoptosis. J Exp Med 2003;198:971-5. (Pubitemid 37152934)
75. Ribatti D, Presta M, Vacca A, Ria R, Giuliani R, Dell'Era P, et al. Human erythropoietin induces a pro-angiogenic phenotype in cultured endothelial cells and stimulates neovascularization in vivo. Blood 1999;93:2627-36. (Pubitemid 29181195)
76. Noguchi T, Asavaritikrai P, Teng R, Jia Y. Role of erythropoietin in the brain. Crit Rev Oncol Hematol 2007;64:159-71. (Pubitemid 47496220)
77. Maiese K, Chong ZZ, Hou J, Shang YC. Oxidative stress: biomarkers and novel therapeutic pathways. Exp Gerontol 2010;45:217-34.