title: Post-conditioning to improve cardiopulmonary resuscitation.
abstract: OBJECTIVE
  Despite decades of advances in prehospital and in-hospital medical care, patients with out-of-hospital cardiac arrest continue to have poor neurologic and cardiac function following otherwise successful resuscitation. This review examines the mechanisms and therapeutic strategies currently under development to activate the post-conditioning pathways and thereby improve survival and function.
  
  
  RESULTS
  Post-conditioning utilizes the reperfusion injury salvage kinase (RISK) and survivor activating factor enhancement (SAFE) pathways as common avenues to promote cell survival and function. Ischemic post-conditioning and multiple medications activate these pathways resulting in improved cardiac and neurological function in animal models of cardiac arrest.
  
  
  CONCLUSIONS
  Detailed knowledge of the RISK and SAFE pathways can be used for further drug development. Human studies are now underway to test some of these strategies, but further clinical trials are necessary to translate these therapies to clinical practice.
authors.affiliation: aDepartment of Medicine, Cardiovascular Division, University of Minnesota, Minneapolis, Minnesota, USA bUJF-Grenoble 1/CNRS/CHU de Grenoble/TIMC-IMAG UMR 5525, Grenoble, France.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Bartos
authors.forename: Guillaume
authors.initials: G
authors.lastname: Debaty
authors.forename: Timothy
authors.initials: T
authors.lastname: Matsuura
authors.forename: Demetris
authors.initials: D
authors.lastname: Yannopoulos
mesh_terms: D000241:Adenosine / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D016572:Cyclosporine / Q000627:therapeutic use; D006146:Guanidines / Q000627:therapeutic use; D006801:Humans; D008929:Mitochondria, Heart / Q000187:drug effects*; D015428:Myocardial Reperfusion Injury / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D017382:Reactive Oxygen Species; D018570:Risk Assessment; D013450:Sulfones / Q000627:therapeutic use; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000889:Anti-Arrhythmia Agents; D006146:Guanidines; D017382:Reactive Oxygen Species; D013450:Sulfones; C093373:cariporide; D016572:Cyclosporine; D000241:Adenosine