title: Cerebral cortical perfusion during and following resuscitation from cardiac arrest in dogs.
abstract: Perfusion of the cerebral cortex during closed chest CPR in dogs, generating systolic pressures of 60 to 70 mmHg, is only 10% of pre-arrest blood flow. In contrast, internal cardiac massage produces normal cortical perfusion rates. Following a 20-min perfusion arrest, during pressure controlled reperfusion, cortical flow rates decay to less than 20% normal after 90 min of reperfusion. This appears to be due to increasing cerebral vascular resistance, and is not due to rising intracranial pressure. The post-arrest cortical hypoperfusion syndrome is prolonged with cortical flow remaining below 20% normal up to 18 hr post arrest. The use of a variety of calcium antagonists, including flunarizine, lidoflazine, verapamil, and Mg2+, immediately post-resuscitation maintains cerebral vascular resistance and cortical perfusion at normal levels. A prospective blind trial of the calcium antagonist lidoflazine following a 15-min cardiac arrest in dogs and resuscitation by internal massage, demonstrates amelioration of neurologic deficit in the early postresuscitation period.
mesh_terms: D000255:Adenosine Triphosphate / Q000378:metabolism; D000818:Animals; D001921:Brain / Q000098:blood supply; D002118:Calcium / Q000378:metabolism; D002462:Cell Membrane / Q000378:metabolism; D002540:Cerebral Cortex / Q000098:blood supply* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002936:Cinnarizine / Q000031:analogs & derivatives / Q000494:pharmacology; D004285:Dogs; D005230:Fatty Acids, Nonesterified / Q000378:metabolism; D005444:Flunarizine; D006323:Heart Arrest / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D006336:Heart Massage; D002534:Hypoxia, Brain / Q000378:metabolism; D007511:Ischemia / Q000378:metabolism; D008013:Lidoflazine / Q000494:pharmacology; D009422:Nervous System Diseases / Q000188:drug therapy; D012151:Resuscitation
chemical_list: D005230:Fatty Acids, Nonesterified; D002936:Cinnarizine; D000255:Adenosine Triphosphate; D008013:Lidoflazine; D005444:Flunarizine; D002118:Calcium