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Pharmacological Resuscitation Interventions

  • Chapter
Cardiopulmonary Resuscitation

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

The primary goal of cardiopulmonary resuscitation (CPR) is to restore spontaneous circulation and manage postresuscitation myocardial dysfunction, including myocardial contractile failure and life-threatening ventricular ectopic dysrhythmias. During CPR, blood flow is determined primarily by two issues: the pump (driving force) and the peripheral vascular resistance. The mechanical interventions are intended to generate maximal cardiac output and perfusion pressure. A second issue is that of vascular tone. Accumulation of metabolic vasodilator substances, including adenosine, carbon dioxide, lactic acid, and hydrogen ions, and diminished neurovascular vasoconstriction decrease peripheral arterial resistance by causing (or allowing) arterial vasodilation. Additionally, there are variable increases in venous capacitance such that venous return to the right atrium is reduced. This has been the basis for the use of vasopressor agents, especially α-adrenergic agents. Quite distinct, however, is immediate postresuscitation management, which has as a primary goal the mitigation of postresuscitation myocardial failure. Pharmacological interventions are designed to improve myocardial systolic function by increasing stroke volume, reducing ventricular filling pressures, and controlling arrhythmias.

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Authors and Affiliations

  1. Institute of Critical Care Medicine, Palm Springs, CA

    Wanchun Tang MD, FCCP, FCCM, Shijie Sun MD, FCCM & Max Harry Weil MD, PhD, MACP, FACC, MasterFCCP, FCCM

  2. Keck School of Medicine, University of Southern California, Los Angeles, CA

    Wanchun Tang MD, FCCP, FCCM, Shijie Sun MD, FCCM & Max Harry Weil MD, PhD, MACP, FACC, MasterFCCP, FCCM

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  1. Wanchun Tang MD, FCCP, FCCM
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  2. Shijie Sun MD, FCCM
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  3. Max Harry Weil MD, PhD, MACP, FACC, MasterFCCP, FCCM
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Editor information

Editors and Affiliations

  1. Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA

    Joseph P. Ornato MD, FACP, FACC, FACEP  & Mary Ann Peberdy MD, FACC  & 

  2. Department of Internal Medicine (Cardiology), Virginia Commonwealth University Health System, Richmond, VA

    Joseph P. Ornato MD, FACP, FACC, FACEP  & Mary Ann Peberdy MD, FACC  & 

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© 2005 Humana Press Inc., Totowa, NJ

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Tang, W., Sun, S., Weil, M.H. (2005). Pharmacological Resuscitation Interventions. In: Ornato, J.P., Peberdy, M.A. (eds) Cardiopulmonary Resuscitation. Contemporary Cardiology. Humana Press. https://doi.org/10.1385/1-59259-814-5:287

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  • DOI: https://doi.org/10.1385/1-59259-814-5:287

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-283-4

  • Online ISBN: 978-1-59259-814-4

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