Glucose Worsens and Tirilizad Improves Neurologic Outcome of CPR

Abstract

While restoration of cardiac and pulmonary function remains the primary focus of traditional CPR, there is a growing interest in assessing, modifying, and restoring cerebral function following CPR. Indeed neurologic deficits are among the most vexing clinical problems brought about by “successful” cardiopulmonary resuscitation. All too often the “successful” patient has restored cardiopulmonary function but exists in a fixed vegetative state. Despite the enormity of this clinical problem, the vast majority of published works focusing on brain or CNS damage tend to address histopathological and biochemical outcomes of ischemic brain damage rather that elemental sensory/motor function. The importance of the anatomical basis of neurologic function is not to be questioned but the basic quality of life of the resuscitated patient is more often determined by fundamental neural function. Degree and quality of consciousness, spontaneous respiration, independent eating and drinking, basic motor functions of walking and getting dressed often do more in determining the real outcome of CPR than complex cognitive and memory skills or the histopathologic integrity of a particular cell layer in the hippocampus. These basic functions represent the elemental functions of the brain and spinal cord and thus present themselves as relevant physiological assessments and clinically important outcomes.