Adenosine, Lidocaine, and Mg2+ (ALM™) Increases Survival and Corrects Coagulopathy After Eight-Minute Asphyxial Cardiac Arrest in the Rat

Abstract

Small bolus of 0.9% NaCl ALM improved survival and hemodynamics following nonhemorrhagic, asphyxial CA and corrected prolonged clot times and clot retraction compared with controls.

Correction of acute traumatic coagulopathy with small-volume 7.5% NaCl adenosine, lidocaine, and Mg2+ occurs within 5 minutes

“…Baseline PT values were similar to our previous rat coagulopathy study 18 and those of García-Manzano et al 26 However, the present study's aPTT baseline values were approximately three times higher, an anomaly we also reported in our 2013 rat asphyxial cardiac arrest study (aPTT, 51 T 8 seconds; PT, 35 T 3 seconds; n = 8). Despite higher baseline aPTT values, 18,19 the present data continue to support a progressive hypcoagulopathy after 20-minute bleed and 60-minute shock. Despite higher baseline aPTT values, 18,19 the present data continue to support a progressive hypcoagulopathy after 20-minute bleed and 60-minute shock.…”

“…19 Whole blood collected in 3.2% sodium citrate tubes was warmed to 37-C. 19 Whole blood collected in 3.2% sodium citrate tubes was warmed to 37-C.…”

“…PT for baseline, sham, bleed, and shock were 31 T 4, 85 T 31, 184 T 43, and 230 T 36 seconds, and aPTTwere 58 T 6, 176 T 38, 231 T 40, and 281 T 19 seconds, respectively. 19 Higher baseline aPTT values since 2012 seem to be associated with a recent change in TriniCLOT's aPTT reaction kit (personal communication 2014). 19 Higher baseline aPTT values since 2012 seem to be associated with a recent change in TriniCLOT's aPTT reaction kit (personal communication 2014).…”

“…15 In contrast, 0.3-mL intravenous (IV) bolus of 7.5% NaCl with adenosine, lidocaine, and magnesium (ALM) resuscitated mean arterial pressure (MAP) into a hypotensive range after 40% to 60% blood loss with no arrhythmias and 100% survival. 18 More recently, we showed that 0.9% NaCl with ALM also corrected, and in some cases prevented, coagulopathy in other trauma states including asphyxial cardiac arrest 19 and polymicrobial sepsis. 18 More recently, we showed that 0.9% NaCl with ALM also corrected, and in some cases prevented, coagulopathy in other trauma states including asphyxial cardiac arrest 19 and polymicrobial sepsis.…”

Immune-inflammatory activation after a single laparotomy in a rat model: effect of adenosine, lidocaine and Mg2+ infusion to dampen the stress response

“…7 The ALM bolus and/or infusion treatments have been shown in rat and pig models to protect against regional myocardial ischemia, lethal arrhythmias, cardiac arrest, hemorrhagic shock, coagulopathy, inflammation, endotoxemia, infection and sepsis. [7][8][9][10][11][12] Adenosine, lidocaine and Mg 2+ alone do not confer these benefits. 7 In the present study, we hypothesized that the low-volume ALM drip/infusion may improve physiologic status in the first few hours following a single laparotomy.…”