Usefulness of Intravenous Sodium Nitrite During Resuscitation for the Treatment of Out-of-Hospital Cardiac Arrest.
Usefulness of Intravenous Sodium Nitrite During Resuscitation for the Treatment of Out-of-Hospital Cardiac Arrest.
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DOI：
10.1016/j.amjcard.2018.04.060
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发表时间：
2018-08-15
期刊：
影响因子：
--
通讯作者：
Nichol G
中科院分区：
文献类型：
--
作者：
Kim F;Dezfulian C;Empey PE;Morrell M;Olsufka M;Scruggs S;Kudenchuk P;May S;Maynard C;Sayre MR;Nichol G
据推测，在院外心脏骤停复苏期间静脉注射亚硝酸钠将提高存活率。我们对120例因室颤(VF)或由西雅图消防局护理人员进行的非室颤初始节律所致的uchA患者在复苏过程中给予(IV)亚硝酸钠进行了一期开放临床研究。共有59名患者接受了25毫克(低剂量)的治疗，61名患者接受了60毫克(高剂量)的亚硝酸钠。治疗效果在高剂量和低剂量亚硝酸组之间进行了比较，并对所有同时登记在本地EMS登记的患者进行了比较。对97例患者进行了全血亚硝酸盐水平测定。低亚硝酸组和高亚硝酸组的ROSC发生率(48%比49%)、野外再停搏(15%比25%)、去甲肾上腺素的使用(12%比12%)、首次收缩压(124±32比125±38 mm Hg)、出院存活率(23.7%比16.4%)和神经功能良好存活率(18.6%比11.5%)均无显著差异。与同期登记对照相比，接受静脉注射亚硝酸盐的患者之间的这些结果没有显著差异。我们估计，60毫克在给药10分钟后达到22-38μM之间的全血亚硝酸盐水平，而25毫克在给药10分钟后达到9-16μM之间的水平。总之，静脉注射亚硝酸盐是可行的，而且似乎是安全的，可以在随后评估静脉注射亚硝酸盐治疗HC A的有效性。ClinicalTrials.gov标识：NCT02987088
It is hypothesized that intravenous (IV) sodium nitrite given during resuscitation of out of hospital cardiac arrest (OHCA) will improve survival. We performed a Phase 1 open-label clinical study of (IV) sodium nitrite given during resuscitation of 120 patents with OHCA from ventricular fibrillation (VF) or non-VF initial rhythms by Seattle Fire Department paramedics. A total of 59 patients received 25 mg (low) and 61 patients received 60 mg (high) of sodium nitrite during resuscitation from OHCA. Treatment effects were compared between high and low dose nitrite groups, and to all patients in a concurrent local EMS registry of OHCA. Whole blood nitrite levels were measured in 97 patients. The rate of ROSC (48% vs. 49%), re-arrest in the field (15% vs. 25%), use of norepinephrine (12% vs. 12%), first systolic blood pressure 124 ± 32 vs. 125 ± 38 mmHg), survival to discharge (23.7% vs. 16.4%) and neurologically favorable survival (18.6% vs. 11.5%) were not significantly different between the low and high nitrite groups. No significant differences in these outcomes were noted between patients who received IV nitrite as compared to concurrent registry controls. We estimate that 60 mg achieves whole blood nitrite levels between 22–38 μM 10 minutes after administration whereas 25 mg achieves a level between 9–16 μM 10 minutes after delivery. In conclusion, administration of IV nitrite is feasible and appears to be safe in patients with OHCA permitting subsequent evaluation of the effectiveness of IV nitrite for the treatment of OHCA. ClinicalTrials.gov Identifier: NCT02987088
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影响因子：
37.8
作者：
Dezfulian C;Shiva S;Alekseyenko A;Pendyal A;Beiser DG;Munasinghe JP;Anderson SA;Chesley CF;Vanden Hoek TL;Gladwin MT
通讯作者：
Gladwin MT
DOI：
10.1016/j.niox.2012.03.007
发表时间：
2012-05-15
期刊：
Nitric oxide : biology and chemistry
影响因子：
--
作者：
Dezfulian C;Alekseyenko A;Dave KR;Raval AP;Do R;Kim F;Perez-Pinzon MA
通讯作者：
Perez-Pinzon MA
影响因子：
82.9
作者：
Cosby, K;Partovi, KS;Gladwin, MT
通讯作者：
Gladwin, MT
影响因子：
3.4
作者：
Serrano-Ponz M;Rodrigo-Gasqué C;Siles E;Martínez-Lara E;Ochoa-Callejero L;Martínez A
通讯作者：
Martínez A
影响因子：
8.3
作者：
Jung, Keun-Hwa;Chu, Kon;Roh, Jae-Kyu
通讯作者：
Roh, Jae-Kyu