Reducing the duration of 100% oxygen ventilation in the early reperfusion period after cardiopulmonary resuscitation decreases striatal brain damage

Brücken, Anne; Kaab, Aaref Bani; Kottmann, Kai; Rossaint, Rolf; Nolte, Kay; Weis, Joachim; Fries, Michael

doi:10.1016/j.resuscitation.2010.06.027

Cited by 55 publications

(27 citation statements)

References 24 publications

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“…19 The deleterious effects of hyperoxia have been studied mostly in animal studies, with a focus on the neurologic effects of hyperoxia and outcome. 6,7 Human data on the titration of FiO2 during and in post-resuscitation care are limited. In 2006 Kuisma and colleagues performed a randomised controlled trial comparing 30% to 100% oxygen in patients with ROSC after OHCA out-of-hospital CA.…”

Section: Discussionmentioning

confidence: 99%

“…2 Animal studies suggest that high arterial blood oxygen concentrations during reperfusion increase oxidative stress, worsening post-ischemic neuronal damage and adversely affecting the activity of the myocardial mitochondria. [3][4][5][6][7] Ventilation with lower fractions of oxygen during CPR might decrease the incidence of immediate hyperoxia after ROSC, but it is unclear if the use of lower oxygen fractions is enough to maintain adequate brain tissue oxygenation during CPR. 5 Means to non-invasively measure cerebral oxygenation during CPR include cerebral oximetry using near-infrared spectroscopy (NIRS), which estimates regional cerebral oxygen saturation (rSO2).…”

Section: Introductionmentioning

confidence: 99%

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The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest

et al. 2017

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The use of 50% oxygen during CPR results in lower cerebral oximetry values compared to 100% oxygen but there is no difference in brain tissue oxygen. Cardiac arrest disturbs cardiac mitochondrial respiration, but it is not alleviated with the use of 50% compared to 100% oxygen (Ethical and hospital approvals ESAVI/1077/04.10.07/2016 and HUS/215/2016, §7 30.3.2016, Funding Helsinki University and others).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest

et al. 2017

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“…Similarly, supra-physiologic levels of oxygen provided to acutely ill patients have the potential to worsen reperfusion injury and outcomes [52,53]. Hyperoxia drives the formation of reactive oxygen species, overwhelming antioxidants at sites of tissue injury; directly injures respiratory epithelium and alveoli inducing inflammation; drives hypercarbia; and leads to absorption atelectasis in the lung.…”

Section: Oxygenation and Outcomesmentioning

confidence: 99%

“…Hyperoxia drives the formation of reactive oxygen species, overwhelming antioxidants at sites of tissue injury; directly injures respiratory epithelium and alveoli inducing inflammation; drives hypercarbia; and leads to absorption atelectasis in the lung. Hyperoxia (PaO 2 > 300 mmHg) immediately following resuscitation is independently associated with poor outcomes in TBI and cardiac arrest [53,54], though not all published data are in accordance [55][56][57].…”

Section: Oxygenation and Outcomesmentioning

confidence: 99%

Emergency Neurological Life Support: Airway, Ventilation, and Sedation

Seder

Jagoda

2015

Neurocrit Care

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Airway management and ventilation are central to the resuscitation of the neurologically ill. These patients often have evolving processes that threaten the airway and adequate ventilation. Furthermore, intubation, ventilation, and sedative choices directly affect brain perfusion. Therefore, airway, ventilation, and sedation was chosen as an emergency neurological life support protocol. Topics include airway management, when and how to intubate with special attention to hemodynamics and preservation of cerebral blood flow, mechanical ventilation settings, and the use of sedative agents based on the patient's neurological status.

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“…In addition to systemic side effects, hyperoxia is also associated with negative effects on brain tissue itself (Brucken et al, 2010;Oter et al, 2005). It is known to induce cerebral vasoconstriction in healthy individuals, leading to a decrease of CBF (Bulte et al, 2007).…”

Section: Side Effects Of Hyperoxic Treatmentmentioning

confidence: 99%

Brain Tissue Oxygen Monitoring and Hyperoxic Treatment in Patients with Traumatic Brain Injury

Beynon

Kiening

Orakcioglu

et al. 2012

Journal of Neurotrauma

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Cerebral ischemia is a well-recognized contributor to high morbidity and mortality after traumatic brain injury (TBI). Standard of care treatment aims to maintain a sufficient oxygen supply to the brain by avoiding increased intracranial pressure (ICP) and ensuring a sufficient cerebral perfusion pressure (CPP). Devices allowing direct assessment of brain tissue oxygenation have showed promising results in clinical studies, and their use was implemented in the Brain Trauma Foundation Guidelines for the treatment of TBI patients in 2007. Results of several studies suggest that a brain tissue oxygen-directed therapy guided by these monitors may contribute to reduced mortality and improved outcome of TBI patients. Whether increasing the oxygen supply to supraphysiological levels has beneficial or detrimental effects on TBI patients has been a matter of debate for decades. The results of trials of hyperbaric oxygenation (HBO) have failed to show a benefit, but renewed interest in normobaric hyperoxia (NBO) in the treatment of TBI patients has emerged in recent years. With the increased availability of advanced neuromonitoring devices such as brain tissue oxygen monitors, it was shown that some patients might benefit from this therapeutic approach. In this article, we review the pathophysiological rationale and technical modalities of brain tissue oxygen monitors, as well as its use in studies of brain tissue oxygen-directed therapy. Furthermore, we analyze hyperoxia as a treatment option in TBI patients, summarize the results of clinical trials, and give insights into the recent findings of hyperoxic effects on cerebral metabolism after TBI.

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Reducing the duration of 100% oxygen ventilation in the early reperfusion period after cardiopulmonary resuscitation decreases striatal brain damage

Cited by 55 publications

References 24 publications

The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest

The effect of 50% compared to 100% inspired oxygen fraction on brain oxygenation and post cardiac arrest mitochondrial function in experimental cardiac arrest

Emergency Neurological Life Support: Airway, Ventilation, and Sedation

Brain Tissue Oxygen Monitoring and Hyperoxic Treatment in Patients with Traumatic Brain Injury

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