The opioid/anti-opioid balance in shock: a new target for therapy in resuscitation.

Abstract:

:Teleologically, pain is of paramount importance for survival and induces the organism to cope in an active way with aggressions from a basically hostile environment. While the activation of endogenous analgesic (opioid) systems typically occurs in conditions of surrender (pre-terminal conditions, sustained tortures, etc.), the activation of endogenous anti-analgesic systems triggers mechanisms of active or passive defence (such as camouflage) aimed at survival. The distinctive features of the main anti-analgesic systems (melanocortinergic, cholecystokininergic, thyroliberinergic) and the dramatic results obtained in experimental pre-terminal conditions (hemorrhagic shock, prolonged respiratory arrest) with the administration of their neuropeptide transmitters (ACTH and several ACTH-fragments, including alpha-MSH, CCK peptides and thyrotropin-releasing hormone) are here reviewed. The study of the mechanisms underlying the resuscitating effects of these neuropeptides has led to the discovery of the (often extremely potent) resuscitating effect of other drugs (protoveratrines, nicotine, centrally-acting cholinergic agents, ganglion-stimulating drugs). It is particularly remarkable that in pre-terminal conditions these neuropeptides and drugs have highly impressive effects on cardiocirculatory parameters at doses that are almost or actually inactive under normal conditions, and that their resuscitating effect is obtained without the need for any other supportive treatment and at dose-levels well below toxic ranges. Finally, in hemorrhage-shocked animals, the treatment with anti-analgesic neuropeptides shortly after bleeding considerably extends the time-limit for an effective and definitively curing blood reinfusion. This would be of self-evident importance in clinical practice, because an extremely simple, non-toxic first-aid treatment in the field, shortly after a massive hemorrhage, could resuscitate the patient for a period sufficient to effectively set up the most appropriate in-hospital treatment.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Bertolini A

doi

10.1016/0300-9572(94)00863-b

subject

Has Abstract

pub_date

1995-08-01 00:00:00

pages

29-42

issue

1

eissn

0300-9572

issn

1873-1570

pii

030095729400863B

journal_volume

30

pub_type

杂志文章,评审
  • Mean arterial pressure and vasopressor load after out-of-hospital cardiac arrest: Associations with one-year neurologic outcome.

    abstract:THE AIM OF THE STUDY:There are limited data on blood pressure targets and vasopressor use following cardiac arrest. We hypothesized that hypotension and high vasopressor load are associated with poor neurological outcome following out-of-hospital cardiac arrest (OHCA). METHODS:We included 412 patients with OHCA includ...

    journal_title:Resuscitation

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.resuscitation.2016.05.026

    authors: Laurikkala J,Wilkman E,Pettilä V,Kurola J,Reinikainen M,Hoppu S,Ala-Kokko T,Tallgren M,Tiainen M,Vaahersalo J,Varpula T,Skrifvars MB,FINNRESUSCI Study Group.

    更新日期:2016-08-01 00:00:00

  • Association between sex and mortality in adults with in-hospital and out-of-hospital cardiac arrest: A systematic review and meta-analysis.

    abstract:OBJECTIVES:Conflicting data exists regarding the association between sex and mortality in adults with in-hospital (IHCA) and out-of-hospital cardiac arrest (OHCA). We therefore conducted a meta-analysis to investigate the association between sex and mortality in adults with IHCA and OHCA. METHODS:We systematically sea...

    journal_title:Resuscitation

    pub_type: 杂志文章,评审

    doi:10.1016/j.resuscitation.2020.07.031

    authors: Parikh PB,Hassan L,Qadeer A,Patel JK

    更新日期:2020-10-01 00:00:00

  • Prediction and risk stratification of survival in accidental hypothermia requiring extracorporeal life support: An individual patient data meta-analysis.

    abstract:BACKGROUND:Extra-corporeal life support (ECLS) is a life-saving intervention for patients with hypothermia induced cardiac arrest or severe cardiovascular instability. However, its application is highly variable due to a paucity of data in the literature to guide practice. Current guidelines and recommendations are bas...

    journal_title:Resuscitation

    pub_type: 杂志文章,meta分析

    doi:10.1016/j.resuscitation.2018.03.028

    authors: Saczkowski RS,Brown DJA,Abu-Laban RB,Fradet G,Schulze CJ,Kuzak ND

    更新日期:2018-06-01 00:00:00

  • Cardiac complications in preterm infants with percutaneous long lines: the importance of early diagnosis.

    abstract::Percutaneous long lines, routinely used in preterm infants, can be associated with several cardiac complications such as pericardial effusion and consequent cardiac tamponade. We report three patients with pericardial effusion highlighting the importance of cardiac ultrasound monitoring to both early diagnosis and tre...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2008.07.023

    authors: Fusco FP,De Carolis MP,Costa S,De Rosa G,Zambraro A,Romagnoli C

    更新日期:2008-12-01 00:00:00

  • Cardiac arrest in Irish general practice: an observational study from 426 general practices.

    abstract:SETTING:Sudden Cardiac Death accounts for approximately 5000 deaths in Ireland each year. Nationally, out-of-hospital cardiac arrest has a very low resuscitation rate, reported at less than 5%. Ireland has a well developed general practice network which routinely manages emergencies arising in the community setting. Ho...

    journal_title:Resuscitation

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.resuscitation.2009.07.010

    authors: Bury G,Headon M,Dixon M,Egan M

    更新日期:2009-11-01 00:00:00

  • Effect of active compression-decompression resuscitation (ACD-CPR) on survival: a combined analysis using individual patient data.

    abstract::Active compression decompression resuscitation (ACD-CPR) has been developed as an alternative to standard cardiopulmonary resuscitation (S-CPR). To determine the effect of ACD-CPR on survival and neurologic outcome in patients with out-of-hospital cardiac arrest, this combined analysis involved individual patient data...

    journal_title:Resuscitation

    pub_type: 杂志文章,meta分析

    doi:10.1016/s0300-9572(99)00073-8

    authors: Mauer DK,Nolan J,Plaisance P,Sitter H,Benoit H,Stiell IG,Sofianos E,Keiding N,Lurie KG

    更新日期:1999-08-01 00:00:00

  • Are European Resuscitation Council recommendations for paddle force achievable during defibrillation?

    abstract::Transthoracic impedance (TTI) is an important determinant of success in defibrillation. Low TTI increases transmyocardial current and therefore increases the chance of depolarising a critical mass of myocardium. A major component of TTI occurs at the paddle-skin interface and is minimised by pressure applied to the de...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/s0300-9572(01)00420-8

    authors: Sado DM,Deakin CD,Petley GW

    更新日期:2001-12-01 00:00:00

  • Life after cardiac arrest; a retrospective study.

    abstract:AIM:We decided to evaluate the life situation of the survivors after out-of-hospital cardiopulmonary resuscitation (CPR). METHOD:CPR survivors who were 75 years or younger at the time and who were discharged alive from the hospital were identified consecutively. Average follow-up time was 25.5 months, and at follow-up...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/0300-9572(95)00903-5

    authors: Sunnerhagen KS,Johansson O,Herlitz J,Grimby G

    更新日期:1996-04-01 00:00:00

  • Safety of the inter-nipple line hand position landmark for chest compression.

    abstract:BACKGROUND:No previous study has investigated the safety of hand position during chest compression determined by the inter-nipple line, in which the heel of one hand is positioned on the centre of the chest between the nipples, from the standpoint of prevention of organ injury. METHODS:We measured the distance from th...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2009.06.030

    authors: Kusunoki S,Tanigawa K,Kondo T,Kawamoto M,Yuge O

    更新日期:2009-10-01 00:00:00

  • Serum magnesium increases following severe hemorrhage in dogs blocked by verapamil treatment.

    abstract::The opening of voltage sensitive calcium channels is an important event in the progression of irreversible shock, allowing the entry of toxic amounts of calcium (Ca2+) into the cells. Because intracellular magnesium (Mg2+) can efflux through these same channels, changes in serum Mg2+ may reflect the patency of these c...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/0300-9572(90)90097-x

    authors: Carroll RG,Iams SG,Pryor WH Jr,Allison EJ Jr

    更新日期:1990-01-01 00:00:00

  • Lightning, sudden cardiac death, simulation and an automated external defibrillator: the perfect storm.

    abstract::This is a report of an 11-year-old boy who had sudden cardiac death after a lightning strike while playing lacrosse at summer camp. The camp staff had performed weekly drills to prepare for various medical emergencies and quickly activated their "Emergency Activation System". The child received immediate cardiopulmona...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2007.02.005

    authors: Nelson KL,Mills W Jr,Umbel S,Crosson JE,Shaffner DH,Hunt EA

    更新日期:2007-09-01 00:00:00

  • Systematic review of quality of life and other patient-centred outcomes after cardiac arrest survival.

    abstract:OBJECTIVES:In cardiac arrest patients (in hospital and pre hospital) does resuscitation produce a good Quality of Life (QoL) for survivors after discharge from the hospital? METHODS:Embase, Medline, The Cochrane Database of Systematic Reviews, Academic Search Premier, the Central Database of Controlled Trials and the ...

    journal_title:Resuscitation

    pub_type: 杂志文章,评审

    doi:10.1016/j.resuscitation.2010.10.030

    authors: Elliott VJ,Rodgers DL,Brett SJ

    更新日期:2011-03-01 00:00:00

  • Effect of time and day of admission on 1-month survival and neurologically favourable 1-month survival in out-of-hospital cardiopulmonary arrest patients.

    abstract:AIM:We sought to examine whether the outcomes of out-of-hospital cardiopulmonary arrest (OHCA) patients differed between weekday and weekend/holiday admissions, or between daytime and nighttime admissions. METHODS:From a national registry of OHCA events in Japan between 2005 and 2008, 173,137 cases where the call-to-h...

    journal_title:Resuscitation

    pub_type: 杂志文章,多中心研究

    doi:10.1016/j.resuscitation.2011.02.007

    authors: Koike S,Tanabe S,Ogawa T,Akahane M,Yasunaga H,Horiguchi H,Matsumoto S,Imamura T

    更新日期:2011-07-01 00:00:00

  • Trends in the incidence and outcome of paediatric out-of-hospital cardiac arrest: A 17-year observational study.

    abstract:BACKGROUND:System-based improvements to the chain of survival have yielded increases in survival from out-of-hospital cardiac arrest (OHCA) in adults. Comparatively little is known about the long-term trends in incidence and survival following paediatric OHCA. METHODS:Between 2000 and 2016, we included children aged ≤...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2018.04.030

    authors: Nehme Z,Namachivayam S,Forrest A,Butt W,Bernard S,Smith K

    更新日期:2018-07-01 00:00:00

  • Improving CPR performance using an audible feedback system suitable for incorporation into an automated external defibrillator.

    abstract:BACKGROUND:It has been shown that a computer-based audible feedback system can improve acquisition and retention of basic life support (BLS) skills. This system is being developed to work in association with an automated external defibrillator (AED). AIM:To determine if such a feedback system is likely to improve the ...

    journal_title:Resuscitation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0300-9572(02)00400-8

    authors: Handley AJ,Handley SA

    更新日期:2003-04-01 00:00:00

  • Effects of epinephrine in a pig model of hypothermic cardiac arrest and closed-chest cardiopulmonary resuscitation combined with active rewarming.

    abstract:OBJECTIVE:The aim of the current study was to assess the effects of epinephrine in a pig model of hypothermic cardiac arrest followed by closed-chest cardiopulmonary resuscitation combined with active rewarming, simulating the clinical management of an arrested hypothermic patient in a hospital without cardiopulmonary ...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/s0300-9572(01)00353-7

    authors: Kornberger E,Lindner KH,Mayr VD,Schwarz B,Rackwitz KS,Wenzel V,Krismer AC,Mair P

    更新日期:2001-09-01 00:00:00

  • Assessment of free radical-induced damage in brain proteins after ischemia and reperfusion.

    abstract::Brain damage initiated during global ischemia has been shown to be exacerbated by iron-dependent lipid peroxidation during early reperfusion. We hypothesized that other cellular components might be involved in similar free radical reactions. In this study we examined three brain protein fractions and ribosomal RNA for...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/0300-9572(92)90162-6

    authors: Krause GS,DeGracia DJ,Skjaerlund JM,O'Neil BJ

    更新日期:1992-02-01 00:00:00

  • Optimal training frequency for acquisition and retention of high-quality CPR skills: A randomized trial.

    abstract:AIM:Spaced training programs employ short, frequent CPR training sessions to improve provider skills. The optimum training frequency for CPR skill acquisition and retention has not been determined. We aimed to determine the training interval associated with the highest quality CPR performance at one year. METHODS:Part...

    journal_title:Resuscitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.resuscitation.2018.10.033

    authors: Anderson R,Sebaldt A,Lin Y,Cheng A

    更新日期:2019-02-01 00:00:00

  • Evaluation of a defibrillator-basic cardiopulmonary resuscitation programme for non medical personnel.

    abstract::To improve the outcome for out-of-hospital patients with ventricular fibrillation/pulseless ventricular tachycardia (VF/VT), the use of automated external defibrillators (AEDs) by first responders including non-medical personnel with a duty to respond to an emergency is recommended. A special CPR-AED course has been d...

    journal_title:Resuscitation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1016/s0300-9572(02)00351-9

    authors: Wik L,Dorph E,Auestad B,Andreas Steen P

    更新日期:2003-02-01 00:00:00

  • Team Emergency Assessment Measure (TEAM) for the assessment of non-technical skills during resuscitation: Validation of the French version.

    abstract:AIM:Evaluation of team performances during medical simulation must rely on validated and reproducible tools. Our aim was to build and validate a French version of the Team Emergency Assessment Measure (TEAM) score, which was developed for the assessment of team performance and non-technical skills during resuscitation....

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2015.11.024

    authors: Maignan M,Koch FX,Chaix J,Phellouzat P,Binauld G,Collomb Muret R,Cooper SJ,Labarère J,Danel V,Viglino D,Debaty G

    更新日期:2016-04-01 00:00:00

  • A comparison of European Trauma Registries. The first report from the EuroTARN Group.

    abstract:UNLABELLED:Trauma management systems have grown in response to regional variations in trauma population, geographical conditions and the provisions of care. National Trauma Registries are being established to improve patient outcomes. However international comparisons could provide the potential to record regional perf...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2007.06.023

    authors: Edwards A,Di Bartolomeo S,Chieregato A,Coats T,Della Corte F,Giannoudis P,Gomes E,Groenborg H,Lefering R,Leppaniemi A,Lossius HM,Ortenwal P,Roise O,Rusnak M,Sturms L,Smith M,Bondegaard Thomsen A,Willett K,Woodford M,

    更新日期:2007-11-01 00:00:00

  • Optimal in-hospital defibrillator placement.

    abstract:AIMS:To determine if mathematical optimization of in-hospital defibrillator placements can reduce in-hospital cardiac arrest-to-defibrillator distance compared to existing defibrillators in a single hospital. METHODS:We identified treated IHCAs and defibrillator placements in St. Michael's Hospital in Toronto, Canada ...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2020.03.018

    authors: Leung KHB,Sun CLF,Yang M,Allan KS,Wong N,Chan TCY

    更新日期:2020-06-01 00:00:00

  • Ventricular fibrillation frequency characteristics and time evolution in piglets: a developmental study.

    abstract:BACKGROUND:Derived variables of ventricular fibrillation, such as the frequency distribution by fast Fourier transformation and its evolution over time, have been used to determine the optimum timing for defibrillation. We hypothesized that these frequency variables would differ among neonatal, young child and older ch...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2004.05.001

    authors: Indik JH,Donnerstein RL,Berg MD,Samson RA,Berg RA

    更新日期:2004-10-01 00:00:00

  • Cardiopulmonary resuscitation standards for clinical practice and training in the UK.

    abstract::The Royal College of Anaesthetists, the Royal College of Physicians, the Intensive Care Society and the Resuscitation Council (UK) have published new resuscitation standards. The document provides advice to UK healthcare organisations, resuscitation committees and resuscitation officers on all aspects of the resuscita...

    journal_title:Resuscitation

    pub_type: 指南,杂志文章,实务指引

    doi:10.1016/j.resuscitation.2004.11.001

    authors: Gabbott D,Smith G,Mitchell S,Colquhoun M,Nolan J,Soar J,Pitcher D,Perkins G,Phillips B,King B,Spearpoint K,Royal College of Anaesthetists.,Royal College of Physicians of London.,Intensive Care Society.,Resuscitation Council.

    更新日期:2005-01-01 00:00:00

  • The effect on quality of chest compressions and exhaustion of a compression--ventilation ratio of 30:2 versus 15:2 during cardiopulmonary resuscitation--a randomised trial.

    abstract:BACKGROUND:Recent cardio pulmonary resuscitation (CPR) guidelines changed the compression:ventilation ratio in 30:2. OBJECTIVE:To compare the quality of chest compressions and exhaustion using the ratio 30:2 versus 15:2. METHODS:A prospective, randomised crossover design was used. Subjects were recruited from the H.-...

    journal_title:Resuscitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.resuscitation.2006.12.004

    authors: Deschilder K,De Vos R,Stockman W

    更新日期:2007-07-01 00:00:00

  • Resuscitation of out-of-hospital cardiac arrest by Asian primary health-care physicians.

    abstract:AIM:To assess the experience, knowledge and attitudes of local primary health-care doctors towards resuscitation in out-of-hospital cardiac arrest. METHODS:We conducted a survey of general practitioners (GPs) working in both private and public sectors. The survey consisted of 29 questions and was self-administered. R...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2004.11.021

    authors: Ong ME,Chan YH,Ang HY,Lim SH,Tan KL

    更新日期:2005-05-01 00:00:00

  • Therapeutic hypothermia in neonates. Review of current clinical data, ILCOR recommendations and suggestions for implementation in neonatal intensive care units.

    abstract::Recent evidence suggests that the current ILCOR guidelines regarding hypothermia for the treatment of neonatal encephalopathy need urgent revision. In 2005 when the current ILCOR guidelines were finalised one large (CoolCap trial, n=235) and one small RCT (n=67), in addition to pilot trials, had been published, and de...

    journal_title:Resuscitation

    pub_type: 杂志文章,评审

    doi:10.1016/j.resuscitation.2008.04.027

    authors: Hoehn T,Hansmann G,Bührer C,Simbruner G,Gunn AJ,Yager J,Levene M,Hamrick SE,Shankaran S,Thoresen M

    更新日期:2008-07-01 00:00:00

  • Analysis of reasons for emergency call delays in Japan in relation to location: high incidence of correctable causes and the impact of delays on patient outcomes.

    abstract:REVIEW:The interval between collapse and emergency call influences the prognosis of out-of-hospital cardiac arrest (OHCA). To reduce the interval, it is essential to identify the causes of delay. METHODS:Basal data were collected prospectively by fire departments from 3746 OHCAs witnessed or recognised by citizens and...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2010.05.022

    authors: Takei Y,Inaba H,Yachida T,Enami M,Goto Y,Ohta K

    更新日期:2010-11-01 00:00:00

  • The significance of clinical experience on learning outcome from resuscitation training-a randomised controlled study.

    abstract:CONTEXT:The impact of clinical experience on learning outcome from a resuscitation course has not been systematically investigated. AIM:To determine whether half a year of clinical experience before participation in an Advanced Life Support (ALS) course increases the immediate learning outcome and retention of learnin...

    journal_title:Resuscitation

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.resuscitation.2008.10.026

    authors: Jensen ML,Lippert F,Hesselfeldt R,Rasmussen MB,Mogensen SS,Jensen MK,Frost T,Ringsted C

    更新日期:2009-02-01 00:00:00

  • Conservative oxygen therapy in mechanically ventilated patients following cardiac arrest: A retrospective nested cohort study.

    abstract:BACKGROUND:In mechanically ventilated (MV) cardiac arrest (CA) survivors admitted to the intensive care unit (ICU) avoidance of hypoxia is considered crucial. However, avoidance of hyperoxia may also be important. A conservative approach to oxygen therapy may reduce exposure to both. METHODS:We evaluated the introduct...

    journal_title:Resuscitation

    pub_type: 杂志文章

    doi:10.1016/j.resuscitation.2015.11.026

    authors: Eastwood GM,Tanaka A,Espinoza ED,Peck L,Young H,Mårtensson J,Zhang L,Glassford NJ,Hsiao YF,Suzuki S,Bellomo R

    更新日期:2016-04-01 00:00:00