title: The future is now: neuroprotection during cardiopulmonary resuscitation.
abstract: OBJECTIVE
  Survival with favorable neurological function after cardiac arrest remains low. The purpose of this review is to identify recent advances that focus on neuroprotection during cardiopulmonary resuscitation (CPR).
  
  
  RESULTS
  Multiple strategies have been shown to enhance neuroprotection during CPR. Brain perfusion during CPR is increased with therapies such as active compression decompression CPR and intrathoracic pressure regulation that improve cardiac preload and decrease intracranial pressure. Head Up CPR has been shown to decrease intracranial pressure thereby increasing cerebral perfusion pressure and cerebral blood flow. Sodium nitroprusside enhanced CPR increases cerebral perfusion, facilitates heat exchange, and improves neurologic survival in swine after cardiac arrest. Postconditioning has been administered during CPR in laboratory settings. Poloxamer 188, a membrane stabilizer, and ischemic postconditioning have been shown to improve cardiac and neural function after cardiac arrest in animal models. Postconditioning with inhaled gases protects the myocardium, with more evidence mounting for the potential for neural protection.
  
  
  CONCLUSIONS
  Multiple promising neuroprotective therapies are being developed in animal models of cardiac arrest, and are in early stages of human trials. These therapies have the potential to be bundled together to improve rates of favorable neurological survival after cardiac arrest.
authors.affiliation: aDepartment of Emergency Medicine, Hennepin County Medical Center bDepartment of Medicine-Cardiovascular Division cDepartment of Integrated Biology and Physiology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Johanna C
authors.initials: JC
authors.lastname: Moore
authors.forename: Jason A
authors.initials: JA
authors.lastname: Bartos
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Matsuura
authors.forename: Demetris
authors.initials: D
authors.lastname: Yannopoulos
mesh_terms: D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004195:Disease Models, Animal; D006323:Heart Arrest / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D000066829:Neuroprotection; D013552:Swine; D016896:Treatment Outcome