Cerebral resuscitation: state of the art, experimental approaches and clinical perspectives

Neuronal injury following global cerebral ischemia continues to bea central problem of patients in the postresuscitation phase following cardiocirculatory arrest. In addition to measures focusing on rapid restoration of spontaneous circulation, the most effective treatment after cardiac arrest, as shown by large randomized trials,is the use of therapeutic mild hypothermia. Current guidelines of the International Liaison Committee on Resuscitation (ILCOR)are recommending the use of therapeutic mild hypothermia for all unconscious patients after cardiac arrest. At present there is no specific neuroprotective treatment available. Promising animal experimental data concerning the use of thrombolytic agents during cardiopulmonary resuscitation have led to a large European multicenter trial (TROICA trial) that will provide its data in 2006.