Aortic-based therapy for cardiac arrest.
After the failure of electrical countershock, the successful treatment of cardiac arrest is a function of raising aortic pressure so as to improve vital organ perfusion. Pharmacologic pressor agents have until recently been the most direct means of increasing aortic pressure. We have now begun to reevaluate direct aortic techniques including occlusion, infusion, counter-pulsation, and combinations of these. Clinical studies have demonstrated that the aorta can be accessed quickly and reliably even under emergency conditions. Initial laboratory studies indicate that some nonpharmacologic aortic therapies hold promise as adjuncts to external chest compression, or even as stand-alone therapies. Considerable research will be needed to identify the most effective approach before clinical trials can be considered.
Paradis
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Department of Medicine, Columbia University College of Physicians and Surgeons, St Luke's-Roosevelt Hospital Center, New York, New York, USA.
D000818:Animals; D001011:Aorta / Q000503:physiopathology*; D001794:Blood Pressure; D016887:Cardiopulmonary Resuscitation; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D004630:Emergencies; D006323:Heart Arrest / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D007423:Intra-Aortic Balloon Pumping / Q000379:methods*; D017211:Treatment Failure