1. Tumor necrosis factor-α is associated with early postresuscitation myocardial dysfunction
- Author
-
Daniel Garner, James T. Niemann, and Roger J. Lewis
- Subjects
Male ,Resuscitation ,medicine.medical_treatment ,Sus scrofa ,Ischemia ,Hemodynamics ,Critical Care and Intensive Care Medicine ,Proinflammatory cytokine ,Ventricular Dysfunction, Left ,Intensive care ,medicine ,Animals ,Cardiopulmonary resuscitation ,Calcium metabolism ,Tumor Necrosis Factor-alpha ,business.industry ,medicine.disease ,Cardiopulmonary Resuscitation ,Disease Models, Animal ,Anesthesia ,Cytokines ,Calcium ,Female ,Tumor necrosis factor alpha ,business - Abstract
OBJECTIVE Left ventricular dysfunction after successful cardiopulmonary resuscitation contributes to early death following resuscitation. The stress-induced proinflammatory cytokines, particularly tumor necrosis factor-alpha and interleukin-1beta, are known to depress myocardial function. We hypothesized that tumor necrosis factor-alpha and interleukin-1beta, synthesized and released in response to the stress of global ischemia accompanying cardiac arrest, play a role in development of postresuscitation left ventricular dysfunction. METHODS Hemodynamic variables, tumor necrosis factor-alpha , interleukin-1beta, interleukin-6 (enzyme-linked immunosorbent assay method), and ionized calcium were measured in ten anesthetized swine before and after 7 mins of cardiac arrest and during the early postresuscitation period (60-90 mins). RESULTS Tumor necrosis factor-alpha increased three-fold within 15 mins of restoration of circulation and remained elevated throughout the observation period. A significant negative correlation was observed between tumor necrosis factor-alpha and left ventricular systolic change in pressure over time (r = -.54, p
- Published
- 2004