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At least 235 records · Page 13Linked to original sources
PubMed1998

[Kidney procurement from a heart-arrest donor].

Brain death occurred in a 47-year-old head trauma patient following 5 days of intensive care. The procedure for multiple organ procurement was initiated. Irreversible cardiac arrest had occurred during the period in the surgical intensive therapy unit. External cardiac massage and mechanical ventilation were maintained until in situ cooling of the kidneys was achieved. The patient was taken to the operating room for nephrectomy. Both kidneys were transplanted with a favorable outcome. Procurement of kidneys from non-heart-beating donors could increase the number of available grafts for transplantation.

Craniocerebral Trauma↗
PubMedDate not supplied

[Heart arrest and reanimation].

The author describes when stoppage of the heart muscle is really true and the most important causes of it. It is an emergency that must be prevented and to achieve this, the premonitory symtoms and their treatment are described.

Heart Arrest↗
PubMed1992

[Heart arrest in excision of large craniopharyngiomas: two cases with successful resuscitation--pathogenic considerations].

A reversible cardiac arrest with successful resuscitation/cardiac massage occurred in two female patients in the context of the relatively radical extirpation of large mainly solid craniopharyngiomas with supraretrosellar and retrochiasmatic extension. Clinical (including ECG) and pathological anatomical investigations (especially after subarachnoid hemorrhages) and the results of animal experiments indicate that the cardiac arrest was caused by an acute functional disturbance in the dorsocaudal hypothalamus. In particular, the coincidence of hemorrhages/ischemia in the hypothalamus and subendocardially as well as the pronounced elevation of catecholamines observed by some authors is noteworthy.

Adult↗
PubMed2004

Myocardial oxygen demand and redox state affect fatty acid oxidation in the potassium-arrested heart.

BACKGROUND: Fatty acid (FA) metabolism is suppressed under conditions of cardioplegic arrest, but the mechanism behind this effect is unknown. We hypothesized that alterations in redox state and oxygen demand control myocardial FA utilization during potassium arrest. METHODS: Rat hearts were perfused with Krebs-Heinseleit buffer containing physiologic concentrations of FAs, ketones, and carbohydrates with unique (13)Carbon labeling patterns. Cytosolic and mitochondrial redox states were altered by manipulating the lactate/pyruvate and ketone redox couples, respectively. Myocardial oxygen consumption was increased by adding the mitochondrial uncoupler 2,4-dinitrophenol to the perfusate. Experiments were conducted under conditions of normokalemic perfusion and potassium cardioplegia (PC). Substrate oxidation rates were derived from (13)Carbon isotopomer data and myocardial oxygen consumption. RESULTS: Continuous perfusion under conditions of potassium arrest dramatically reduced fatty acid oxidation. Both the addition of 2,4-dinitrophenol and alteration of mitochondrial redox state significantly increased FA oxidation during PC. In contrast to normokalemic perfusion, altering cytosolic redox state during PC did not change FA oxidation. CONCLUSIONS: These data suggest that mitochondrial redox state and oxygen demand are important determinants of myocardial FA oxidation during potassium arrest. FA oxidation appears to be regulated by different factors during PC than normokalemic perfusion.

Acetyl Coenzyme A↗
PubMed1979

[Direct cardiac massage in refractory heart arrest. 2 cases sucessfully treated in the coronary care unit].

The open chest, or direct cardiac massage may be indicate in instances where closed chest techniques are ineffective. Direct cardiac massage was successfully applied by us in two patients who failed to resuscitate with closed chest massage. The patients, an 49 year old man with acute myocardial infarction and an 53 year old man who had a history of previous myocardial infarction with subsequent development of a ventricular aneurysm, had ventricular fibrillation who not responded to closed chest cardiac massage and to repeated electrical countershocks. When the pupils became dilated the decision was made to open the chest and apply direct massage. After several minutes of manual cardiac compression a single D.C. countershock returned the heart to a normal sinus rhythm in each of the patients. Although the thoracotomy was performed outside the operating room, none of the complications of the open chest resuscitation occurred, such as intrathoracic infection, rupture of the heart, and postresuscitative bleeding. The first patient recovered from the infarction, has been discharged from the hospital and is alive and well after 5 months. The second patient has been discharged from the U.C.C. and is alive and well after 15 days.

Electric Countershock↗
PubMed1975

[Metabolism and ultrastructure of magnesium aspartate-procaine arrested hearts of rabbit and man (author's transl)].

In normothermia, mild, and deep hypothermia the metabolism and the electron microscopic structure were investigated in human and rabbit heart muscle after magnesium aspartate-procaine cardioplegia. In comparison to plain ischaemic arrest splitting of adenine nucleotides and glycogen was significantly reduced in all experiments with the induced cardioplegic arrest. For 40 min at 32 degrees C almost no changes in ultrastructure were seen in heart muscle after induced arrest, while severe and/or irreversible damages were seen in the cell structure of the heart muscle due to plain ischaemic arrest.

Adenine Nucleotides↗
PubMed1990

[Relationship between arrhythmia profile, left ventricular function and sudden death in the post-infarct period of patients resuscitated from heart arrest].

In order to determine the relationship among ventricular arrhythmias, left ventricular dysfunction and sudden cardiac death (SCD), 75 consecutive patients with myocardial infarction, 38 of whom resuscitated from SCD, were studied retrospectively by 48 hour Holter electrocardiographic monitoring (ECGD), cardiac catheterization and radionuclide angiography (ACRD). The patients were divided in 3 groups, related to SCD occurrence and to the interval between acute myocardial infarction (AMI) and SCD: Group I (37 patients-control group) no cardiac arrest occurred; Group II (26 patients) resuscitated less than or equal to 48 hours after AMI; Group III (12 patients) resuscitated 6-12 weeks after AMI. ECGDs were recorded with an average of 2 (ECGD 1), 16 (ECGD 2) and 36 months (ECGD 3) after AMI. In ECGD 1, there were no differences in the frequency and complexity of ventricular arrhythmias among the 3 groups, whereas in ECGD 2 and 3 the incidence of complex ventricular arrhythmias was significantly higher in Group III than in the other 2 groups (p less than 0.05). In Group III, the complexity and frequency of ventricular arrhythmias increased both in ECGD 2 and 3 compared to ECGD 1 (p less than 0.05). Furthermore, between patients of Group II and III higher grade arrhythmias and more frequent ventricular premature beats (VPB) were noted in sudden death patients than in survivors. There was no statistical difference in mean cardiac index, left ventricular end-diastolic pressure and ejection fraction among the groups. In the ACRD 1 performed an average of 8 months after AMI, a slight decrease of ejection fraction in Group III compared to the other groups was noted (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

Interstitial pH value in the myocardium as indicator of ischemic stress of cardioplegically arrested hearts.

The influence of different cardioplegic methods (Bretschneider, Cardiac Surgery in Hamburg, Kirklin, St. Thomas' Hospital in London) on the progressive myocardial acidosis during global ischemia of up to 24 hours' duration was investigated in arrested, nonperfused canine hearts (n = 36). The increasing acidosis of the ischemic heart muscle was continuously measured and registered with the aid of interstitial pH measurement (pHi) using glass implant electrodes. With various buffered and unbuffered cardioplegic solutions there were relatively wide fluctuations of the pHi courses in the myocardial extracellular space. The "critical" interstitial pH values ("pHcrit") relative to a defined myocardial ATP concentration (4 mumol/g ww) vary between 6.10 (Bretschneider) and 5.6 (Kirklin) (p less than 0.001). These striking results cannot be attributed solely to different total myocardial lactate concentrations, but variations in a "cellular" and an "extracellular factor" must also be taken into account. Measurement of interstitial pH for intraoperative monitoring of myocardial ischemic stress can therefore be used only within limits and with knowledge of the specific protective procedure applied. The method continues an important tool in basic investigations of partial or global ischemia of organs, particularly as regards the spectrum of metabolic, morphological and functional parameters.

Acidosis↗