Mild Therapeutic Hypothermia for Treatment of Cardiac Arrest: Current Results and Future Perspectives

摘要

Sudden cardiac arrest remains a major unresolved public health problem. It is still the leading cause of death, and few cardiopulmonary-cerebral resuscitation (CPCR) attempts on cardiac arrest victims result in neurologically intact long-term survivors [1,2].The pathogenesis of cerebral ischemia and post-ischemic encephalopathy are multifactorial and only partially understood [2-5]. Brain ischemia results in rapid loss of high-energy phosphate compounds [6] and generalized membrane depolarization with an increase in intracellular calcium and the release of large amounts of glutamate [4]. These mechanisms initiate multiple independent chemical cascades and fatal pathways during reperfusion, resulting in neuronal death due to necrosis and apoptosis [5]. Due to the multifactorial pathogenesis of post-arrest neuronal death, multifaceted treatment strategies or a combination of single-molecule targeted drugs is required to achieve survival without brain damage [7,8].