Life After Death: Surviving Cardiac Arrest—an Overview of Epidemiology, Best Acute Care Practices, and Considerations for Rehabilitation Care

Sawyer, Kelly N.; Callaway, Clifton W.; Wagner, Amy K.

doi:10.1007/s40141-017-0148-7

Cited by 7 publications

(3 citation statements)

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“…Given the drug's clinical relevance, and the premise that VF‐CA patients may not respond to DA agonists in the same manner as TBI patients (Sawyer et al . ), we chose MPH as a clinically relevant, and effective, agent to assess DA neurotransmission response with pharmacological manipulation. Specifically, we found that there were larger changes in DA in the D‐Str for the VF‐CA group compared to Shams, findings which may have implications for VF‐CA‐associated behavioral sequelae.…”

Section: Discussionmentioning

confidence: 99%

“…; Sawyer et al . ), along with our own clinical experience (Pinto et al . ), suggests that DA stimulants worsen cognitive and motor symptoms associated with HIBI, and alternative neuropharmacology is needed and can improve functional recovery.…”

mentioning

confidence: 80%

“…Clinically, individuals surviving CA have many of the same cognitive behavioral features as those with significant traumatic brain injury (TBI) (Sawyer et al . ) and many impairments associated with TBI relate to striatal dopamine system dysfunction that occurs without overwhelming evidence of direct striatal damage in both clinical populations (Wagner et al . ) and experimental studies (Yan et al .…”

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confidence: 99%

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Ventricular fibrillation cardiac arrest produces a chronic striatal hyperdopaminergic state that is worsened by methylphenidate treatment

Nora

Harun

Fine

et al. 2017

Journal of Neurochemistry

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Cardiac arrest survival rates have improved with modern resuscitation techniques, but many survivors experience impairments associated with hypoxic-ischemic brain injury (HIBI). Currently, little is understood about chronic changes in striatal dopamine (DA) systems after HIBI. Given the common empiric clinical use of DA enhancing agents in neurorehabilitation, investigation evaluating dopaminergic alterations after cardiac arrest (CA) is necessary to optimize rehabilitation approaches. We hypothesized that striatal DA neurotransmission would be altered chronically after ventricular fibrillation cardiac arrest (VF-CA). Fast-scan cyclic voltammetry was used with median forebrain bundle (MFB) maximal electrical stimulations (60Hz, 10s) in rats to characterize presynaptic components of DA neurotransmission in the dorsal striatum (D-Str) and nucleus accumbens 14 days after a 5-min VF-CA when compared to Sham or Naïve. VF-CA increased D-Str-evoked overflow [DA], total [DA] released, and initial DA release rate versus controls, despite also increasing maximal velocity of DA reuptake (V ). Methylphenidate (10 mg/kg), a DA transporter inhibitor, was administered to VF-CA and Shams after establishing a baseline, pre-drug 60 Hz, 5 s stimulation response. Methylphenidate increased initial evoked overflow [DA] more-so in VF-CA versus Sham and reduced D-Str V in VF-CA but not Shams; these findings are consistent with upregulated striatal DA transporter in VF-CA versus Sham. Our work demonstrates that 5-min VF-CA increases electrically stimulated DA release with concomitant upregulation of DA reuptake 2 weeks after brief VF-CA insult. Future work should elucidate how CA insult duration, time after insult, and insult type influence striatal DA neurotransmission and related cognitive and motor functions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 80%

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