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Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments

Despite recent advances in the management of post–cardiac arrest syndrome (PCAS), the survival rate, without neurologic sequelae after resuscitation, remains very low. Whole-body ischemia, followed by reperfusion after cardiac arrest (CA), contributes to PCAS, for which established pharmaceutical in...

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Autores principales: Hayashida, Kei, Miyara, Santiago J., Shinozaki, Koichiro, Takegawa, Ryosuke, Yin, Tai, Rolston, Daniel M., Choudhary, Rishabh C., Guevara, Sara, Molmenti, Ernesto P., Becker, Lance B.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873953/
https://www.ncbi.nlm.nih.gov/pubmed/33585501
http://dx.doi.org/10.3389/fmed.2020.586229
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author Hayashida, Kei
Miyara, Santiago J.
Shinozaki, Koichiro
Takegawa, Ryosuke
Yin, Tai
Rolston, Daniel M.
Choudhary, Rishabh C.
Guevara, Sara
Molmenti, Ernesto P.
Becker, Lance B.
author_facet Hayashida, Kei
Miyara, Santiago J.
Shinozaki, Koichiro
Takegawa, Ryosuke
Yin, Tai
Rolston, Daniel M.
Choudhary, Rishabh C.
Guevara, Sara
Molmenti, Ernesto P.
Becker, Lance B.
author_sort Hayashida, Kei
collection PubMed
description Despite recent advances in the management of post–cardiac arrest syndrome (PCAS), the survival rate, without neurologic sequelae after resuscitation, remains very low. Whole-body ischemia, followed by reperfusion after cardiac arrest (CA), contributes to PCAS, for which established pharmaceutical interventions are still lacking. It has been shown that a number of different processes can ultimately lead to neuronal injury and cell death in the pathology of PCAS, including vasoconstriction, protein modification, impaired mitochondrial respiration, cell death signaling, inflammation, and excessive oxidative stress. Recently, the pathophysiological effects of inhaled gases including nitric oxide (NO), molecular hydrogen (H(2)), and xenon (Xe) have attracted much attention. Herein, we summarize recent literature on the application of NO, H(2), and Xe for treating PCAS. Recent basic and clinical research has shown that these gases have cytoprotective effects against PCAS. Nevertheless, there are likely differences in the mechanisms by which these gases modulate reperfusion injury after CA. Further preclinical and clinical studies examining the combinations of standard post-CA care and inhaled gas treatment to prevent ischemia–reperfusion injury are warranted to improve outcomes in patients who are being failed by our current therapies.
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spelling pubmed-78739532021-02-11 Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments Hayashida, Kei Miyara, Santiago J. Shinozaki, Koichiro Takegawa, Ryosuke Yin, Tai Rolston, Daniel M. Choudhary, Rishabh C. Guevara, Sara Molmenti, Ernesto P. Becker, Lance B. Front Med (Lausanne) Medicine Despite recent advances in the management of post–cardiac arrest syndrome (PCAS), the survival rate, without neurologic sequelae after resuscitation, remains very low. Whole-body ischemia, followed by reperfusion after cardiac arrest (CA), contributes to PCAS, for which established pharmaceutical interventions are still lacking. It has been shown that a number of different processes can ultimately lead to neuronal injury and cell death in the pathology of PCAS, including vasoconstriction, protein modification, impaired mitochondrial respiration, cell death signaling, inflammation, and excessive oxidative stress. Recently, the pathophysiological effects of inhaled gases including nitric oxide (NO), molecular hydrogen (H(2)), and xenon (Xe) have attracted much attention. Herein, we summarize recent literature on the application of NO, H(2), and Xe for treating PCAS. Recent basic and clinical research has shown that these gases have cytoprotective effects against PCAS. Nevertheless, there are likely differences in the mechanisms by which these gases modulate reperfusion injury after CA. Further preclinical and clinical studies examining the combinations of standard post-CA care and inhaled gas treatment to prevent ischemia–reperfusion injury are warranted to improve outcomes in patients who are being failed by our current therapies. Frontiers Media S.A. 2021-01-14 /pmc/articles/PMC7873953/ /pubmed/33585501 http://dx.doi.org/10.3389/fmed.2020.586229 Text en Copyright © 2021 Hayashida, Miyara, Shinozaki, Takegawa, Yin, Rolston, Choudhary, Guevara, Molmenti and Becker. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Hayashida, Kei
Miyara, Santiago J.
Shinozaki, Koichiro
Takegawa, Ryosuke
Yin, Tai
Rolston, Daniel M.
Choudhary, Rishabh C.
Guevara, Sara
Molmenti, Ernesto P.
Becker, Lance B.
Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments
title Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments
title_full Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments
title_fullStr Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments
title_full_unstemmed Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments
title_short Inhaled Gases as Therapies for Post–Cardiac Arrest Syndrome: A Narrative Review of Recent Developments
title_sort inhaled gases as therapies for post–cardiac arrest syndrome: a narrative review of recent developments
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873953/
https://www.ncbi.nlm.nih.gov/pubmed/33585501
http://dx.doi.org/10.3389/fmed.2020.586229
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