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Calcium Antagonism in Cardiopulmonary Resuscitation

Published online by Cambridge University Press:  17 February 2017

G.H. Meuret
Affiliation:
Institute for Anesthesiology, Hugstetterstrasse 55, University of Freiburg, Freiburg im Breisgau, West Germany
H. Themann
Affiliation:
Münster, West Germany

Extract

Drugs for CPR need reinvestigation; at the present time their use is as much an art as a science (14). American Heart Associations standards and guidelines and other recommendations for CPR call for the administration of 500 mg CaC12 i.v. routinely, in attempts to resuscitate patients with asystole or electromechanical dissociation (1). However, calcium's popularity for use in restarting the arrested heart has fallen (3,6,14).

There is a lack of evidence in the literature for calcium's supposed beneficial role in cardiac resuscitation. Calcium in combination with epinephrine — the traditional drug of choice in CPR — was not experimentally investigated before. On the other hand, the effects of calcium antagonists were never examined in CPR, but several theoretical considerations seemed to favor their use. However, a proposed use of calcium antagonists during CPR would lead to the withdrawal of current recommendations for the use of calcium.

Type
Section Two—Clinical Topics
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

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References

1 American Heart Association. Standards and guidelines for cardiopulmonary resuscitation and emergency cardiac care. JAMA 1980; 244:453508.Google Scholar
2 Bush, LR, Schlafer, M, Jolly, SR, et al. Protective effects of diltiazem during myocardial ischemia inisolated cat hearts. JPharmacol Exp Ther 1981; 218:653661.Google Scholar
3 Carlon, GC, Howland, WS, Goldliner, PL, et al. Adverse effects of calcium administration. Report of two cases. Arch Surg 1978; 113:882885.CrossRefGoogle ScholarPubMed
4 Clark, RE, Kristlieb, IY, Henry, PD. Nifedipine, a myocardial protective agent. Am J Cardiol 1979; 44:825831.Google Scholar
5 Clusin, WT, et al. The effects of diltiazem and reduced serum ionized calcium on ischemic ventricular fibrillation in the dogs. Circ Res 1982; 50:518526.Google Scholar
6 Dembo, DH. Calcium in advanced life support. Crit Care Med 1981; 9:358359.CrossRefGoogle ScholarPubMed
7 Fleckenstein, A. Specific inhibitors and promoters of calcium action in the excitation-contraction coupling of the heart muscle and their role in the production or prevention of myocardial lesions. In, Harris, P, Opie, L (eds). Calcium and the Heart. London-New York: Academic Press, 1971:135188.Google Scholar
8 Fleckenstein, A, Hashimoto, K, Herrmann, M, et al. New Calcium Antagonists: Recent Developments and Prospects. Stuttgart-New York: G. Fischer Publ., 1983.Google Scholar
9 Fleckenstein, A. Calcium antagonism in heart and smooth muscle. New York-Chichester-Brisbane-Toronto-Singapore: Wiley-Interscience Publ., 1983.Google Scholar
10 Henry, PD, Shuchleib, R, Borda, LJ, et al. Effects of nifedipine on myocardial perfusion and ischemic injury in dogs. Circ Res 1978; 43:372380.Google Scholar
11 Jolly, SR, Menahan, LA, Gross, GJ. Diltiazem in myocardial recovery from global ischemia and reperfusion. J Mol Cell Cardiol 1981; 13:359372.CrossRefGoogle ScholarPubMed
12 Katz, AM, Reuter, H. Cellular calcium and cardiac cell death. Am J Cardiol 1979; 44: 188190.Google Scholar
13 Nayler, WG, Poole-Wilson, PA, Williams, AJ. Hypoxia and calcium. J Mol Cell Cardiol 1979; 11:683706.CrossRefGoogle ScholarPubMed
14 Safar, P. Cardiopulmonary-Cerebral Resuscitation. Stavanger: Laerdal Publ. and Philadelphia: Saunders Publ., 1981.Google Scholar
15 Shen, AC, Jennings, RB. Kinetics of calcium accumulation in acute myocardial ischemic injury. Am J Pathol 1972; 67:441451.Google Scholar
16 Weishaar, R, Bing, RJ. The beneficial effect of a calcium channel blocker diltiazem on the ischemic-reperfused heart. J Mol Cell Cardiol 1980; 12:9931009.Google Scholar