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2017 ; 25
(1
): 66
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Controlled automated reperfusion of the whole body after 120 minutes of
Cardiopulmonary resuscitation: first clinical report
#MMPMID28693585
Trummer G
; Supady A
; Beyersdorf F
; Scherer C
; Wengenmayer T
; Umhau M
; Benk C
Scand J Trauma Resusc Emerg Med
2017[Jul]; 25
(1
): 66
PMID28693585
show ga
BACKGROUND: Cardiopulmonary resuscitation (CPR) is associated with a high
mortality rate. Furthermore, the few survivors often have severe, persistent
cerebral dysfunction. A potential cause for this unsatisfactory outcome after CPR
is the combination of cardiac arrest (ischemia) and the inability to restore
adequate hemodynamics during conventional CPR (reperfusion), resulting in
ischemia/reperfusion injury of the whole body. Therefore we developed a concept
counteracting this ischemia/reperfusion injury during the process of CPR. CASE
PRESENTATION: We present data from a patient, in whom the concept of a novel
controlled automated reperfusion of the whole body (CARL) was applied after
120 min of CPR under normothermic conditions. The patient survived without
cerebral deficits and showed full recovery of all organs after prolonged cardiac
arrest (CA) except for the spinal cord, where a defect at the level of the 11th
thoracic vertebra caused partial loss of motoric function of the legs.
CONCLUSION: This is the first reported clinical application of CARL after CA. The
implementation of CARL resulted in unexpected survival and recovery after
prolonged normothermic CA and CPR. In synopsis with the preclinical experience in
pigs this case shows, that the new concept of CARL treating ischemia/reperfusion
during the CPR may be an important element within the future treatment of CA.
TRIAL REGISTRATION: Trial was retrospectively registered in the "German Clinical
Trials Register" ( www.germanctr.de ) under No.: DRKS00005773 on July 28th, 2015.