brain stem death as the vital determinant for resumption of spontaneous circulation after cardiac arrest in rats脑干死亡的重要因素在大鼠心脏骤停后恢复自然循环.pdfVIP

Brain Stem Death as the Vital Determinant for Resumption of Spontaneous Circulation after Cardiac Arrest in Rats 1,2 3 1,4 1,2 Alice Y. W. Chang *, Julie Y. H. Chan , Yao-Chung Chuang , Samuel H. H. Chan * 1 Center for Translational Research in Biomedical Sciences, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung County, Taiwan, Republic of China, 2 Center for Neuroscience, National Sun Yat-sen University, Kaohsiung, Taiwan, Republic of China, 3 Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, Republic of China, 4 Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung County, Taiwan, Republic of China Abstract Background: Spontaneous circulation returns to less than half of adult cardiac arrest victims who received in-hospital resuscitation. One clue for this disheartening outcome arises from the prognosis that asystole invariably takes place, after a time lag, on diagnosis of brain stem death. The designation of brain stem death as the point of no return further suggests that permanent impairment of the brain stem cardiovascular regulatory machinery precedes death. It follows that a crucial determinant for successful revival of an arrested heart is that spontaneous circulation must resume before brain stem death commences. Here, we evaluated the hypothesis that maintained functional integrity of the rostral ventrolateral medulla (RVLM), a neural substrate that is intimately related to brain stem death and central circulatory regulation, holds the key to the vital time-window between cardiac arrest and resumption of spontaneous circulation.