Radhakrishnan J, Wang S, Ayoub IM, Kolarova JD, Levine RF, Gazmuri RJ. Circulating levels of cytochrome c after resuscitation from cardiac arrest: a marker of mitochondrial injury and predictor of survival.

NHE-1 inhibition may represent a novel and remarkably effective intervention for resuscitation from VF.

overload yielding levels that corresponded to 77% and 71% of control hearts at VF/CC and PR, without differences among specific Na ϩ -limiting interventions. Limiting sarcolemmal Na ϩ entry attenuated reductions in left ventricular compliance during VF and prompted higher mean aortic pressure (110 Ϯ 7 vs. 95 Ϯ 11 mmHg, P Ͻ 0.001) and higher cardiac work index (159 Ϯ 34 vs. 126 Ϯ 29 g ⅐ m ⅐ min Ϫ1 ⅐ kg Ϫ1 , P Ͻ 0.05) with lesser increases in circulating cardiac troponin I at 60 min PR. Conclusions: Na ϩ -limiting interventions prevented excess Ca 2ϩ m accumulation induced by ischemia and reperfusion and ameliorated myocardial injury and dysfunction. calcium; cardiopulmonary resuscitation; myocardial ischemia; sodium

Improved outcome after prolonged untreated ventricular fibrillation may result from strategies that provide chest compression before attempting defibrillation and avoid early and repetitive defibrillation attempts. The amplitude and frequency characteristics of the ventricular fibrillation waveform could help identify the optimal timing for attempting electrical defibrillation.