Experimental Treatment for Preservation of Mechanically Competent Cardiac Activity Following Cardiac Arrest

Abstract

It has been suggested that sudden cardiac arrest may affect as many as 6.8 million individuals annually (~1:1,000 people) [1, 2]. In the United States, every year approximately 300,000 individuals suffer an episode of out-of-hospital sudden cardiac arrest [3]. Efforts to reestablish life are formidably challenging, requiring not only that cardiac activity be reestablished but that injury to vital organs be prevented, minimised, or reversed. Resuscitation methods yield an average survival and hospital discharge rate with intact neurological function that approaches 7.9% in the United States [4], 10.7% in Europe [5], and only 1.0% in the rest of the world [6]. In the United States, efficient emergency medical service systems can initially reestablish cardiac activity in approximately 30% of individuals [7–9] with >40% dying before hospital admission [10]. Of those admitted to hospital, nearly 75% die before hospital discharge due to variable degrees of myocardial or neurological dysfunction, systemic inflammation, intercurrent illnesses, or a combination thereof [10–12]. Thus, initial reestablishment of cardiac activity using available resuscitation treatments does not ensure ultimate survival.