Cerebral resuscitation after global brain ischemia: linking research to practice

Despite significant advances in resuscitation medicine, neurologic recovery continues to be the major limiting factor in achieving successful resuscitation outcomes. Clinicians must recognize that successful resuscitation outcomes are not limited to the restoration of normal cardiac rhythm and hemodynamics, but rather the restoration of human mentation. It is well recognized that a cascade of injurious events begins within minutes of ischemia and that ischemic and postischemic events cause significant neuronal damage. An increased understanding of the pathophysiology of global brain ischemia provides evidence of a therapeutic window of opportunity during which interventions hold the potential to improve neurologic outcome. The research basis for understanding global brain ischemia, its clinical prognosis, and potential intervention strategies are examined.