Divalent ions in cardiopulmonary-cerebral resuscitation

The science of resuscitation has advanced considerably during the past 25 years as a consequence of modern cardiopulmonary resuscitation (CPR). Complete cerebral ischemia for more than 6 min will result in irreversible brain damage in human subjects. However, recent studies suggest that there may be time-dependent therapeutic measures which could improve the neurologic outcome after CPR. These studies suggest that cerebral ischemia is multifactorial in nature and that Ca2+, Mg2+ and Fe2+ ions are important in producing the sequential events which take place at a cellular level. Therefore, a variety of specific and nonspecific calcium entry blockers (e.g. nimodipine, lidoflazine and Mg2+), N-methyl-D-aspartate blockers (e.g. MK-801), and an iron-chelating agent (e.g. deferoxamine) may prove useful as therapeutic agents.