The Role of Oxygen in Cardiac Arrest Resuscitation
1,The Ohio State University
DOI: 10.22514/SV51.092010.6 Vol.5,Issue S1,September 2010 pp.28-31
Published: 07 September 2010
The heart is incapable of storing significant oxygen or substrates and thus is entirely dependent on a continuous delivery of flow in order to support its high metabolic state. Following cardiac arrest, myocardial tissue oxygen tension falls rapidly and aerobic production of ATP ceases. Without re-oxygenation of the ischemic myocardium, return of spontaneous circula-tion (ROSC) cannot be achieved. The oxygen paradox which has been described regarding other ischemia-reperfusion conditions seems to have application in cardiac arrest. It is clear that some level of oxygenation is necessary to achieve ROSC, however post ROSC there appears to be increased toxicity associated with hyperoxia. The optimal conditions for re-oxygenation in the setting of cardiac arrest remain ill defined at present.
cardiac arrest, oxygen, myocard, oxygen delivery, Adenos-ine-5'-triphosphate (ATP), mitochon-dria, measurement of tissue oxygen, oxygen paradox
MARK G. ANGELOS. The Role of Oxygen in Cardiac Arrest Resuscitation. Signa Vitae. 2010. 5(S1);28-31.
1. Polentini MS, Pirrallo RG, McGill W. The changing incidence of ventricular fibrillation in Milwaukee, Wisconsin (1992-2002). Prehosp Emerg Care 2006;10(1):52-60.
2. Cobb LA, Fahrenbruch CE, Olsufka M, Copass MK. Changing incidence of out-of-hospital ventricular fibrillation, 1980-2000. JAMA 2002;288(23):3008-13.
3. Yeh ST, Cawley RJ, Aune SE, Angelos MG. Oxygen requirement during cardiopulmonary resuscitation (CPR) to effect return of spontane-ous circulation. Resuscitation 2009;80:951-9.
4. Angelos MG, Rath DP, Zhu H, Beckley PD, Robitaille PM. Flow requirements in ventricular fibrillation: An in vivo nuclear magnetic resonance analysis of the left ventricular high-energy phosphate pool. Ann Emerg Med 1999;34(5):583-8.
5. Lesnefsky EJ, Moghaddas S, Tandler B, Kerner J, Hoppel CL. Mitochondrial dysfunction in cardiac disease: ischemia--reperfusion, aging, and heart failure. J Mol Cell Cardiol. 2001;33(6):1065-89.
6. Yeh ST, Lee HL, Aune SE, Chen CL, Chen YR, Angelos MG. Preservation of mitochondrial function with cardiopulmonary resuscitation in prolonged cardiac arrest in rats. J Mol Cell Cardiol 2009;47(6):789-97.
7. Angelos MG, Kutala VK, Torres CA, He G, Stoner JD, Mohammad M, et al. Hypoxic reperfusion of the ischemic heart and oxygen radical generation. Am J Physiol Heart Circ Physiol 2006;290(1):341-7.
8. Ilangovan G, Zweier JL, Kuppusamy P. Mechanism of oxygen-induced EPR line broadening in lithium phthalocyanine microcrystals. J Magn Reson 2004;170(1):42-8.
9. Zhao X, He G, Chen YR, Pandian RP, Kuppusamy P, Zweier JL. Endothelium-derived nitric oxide regulates postischemic myocardial oxy-genation and oxygen consumption by modulation of mitochondrial electron transport. Circulation 2005;111(22):2966-72.
10. Okamoto F, Allen BS, Buckberg GD, Bugyi H, Leaf J. Reperfusion conditions: importance of ensuring gentle versus sudden reperfusion during relief of coronary occlusion. J Thorac Cardiovasc Surg 1986;92(3 Pt 2):613-20.
11. Peng CF, Murphy ML, Colwell K, Straub KD. Controlled versus hyperemic flow during reperfusion of jeopardized ischemic myocardium. Am Heart J 1989;117(3):515-22.
12. Sato H, Jordan JE, Zhao ZQ, Sarvotham SS, Vinten-Johansen J. Gradual reperfusion reduces infarct size and endothelial injury but aug-ments neutrophil accumulation. Ann Thorac Surg 1997;64(4):1099-107.
13. Roy S, Khanna S, Bickerstaff AA, Subramanian SV, Atalay M, Bierl M, et al. Oxygen sensing by primary cardiac fibroblasts: a key role of p21(Waf1/Cip1/Sdi1). Circ Res 2003;92(3):264-71.
14. Richards EM, Fiskum G, Rosenthal RE, Hopkins I, McKenna MC. Hyperoxic reperfusion after global ischemia decreases hippocampal energy metabolism. Stroke 2007;38(5):1578-84.
15. Vereczki V, Martin E, Rosenthal RE, Hof PR, Hoffman GE, Fiskum G. Normoxic resuscitation after cardiac arrest protects against hippo-campal oxidative stress, metabolic dysfunction, and neuronal death. J Cereb Blood Flow Metab 2006;26(6):821-35.
16. Balan IS, Fiskum G, Hazelton J, Cotto-Cumba C, Rosenthal RE. Oximetry-guided reoxygenation improves neurological outcome after experimental cardiac arrest. Stroke 2006;37(12):3008-13.
17. Kilgannon JH, Jones AE, Shapiro NI, Angelos MG, Micarek B, Hunter K, et al. Association between arterial hyperoxia following resuscitation from cardiac arrest and in-hospital mortality. JAMA 2010;303(21):2165-71.
Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.
Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.
Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.
IndexCopernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.
Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.
Scopus: CiteScore 0.5(2019) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.
Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.