Publications

While calcium administration has been recommended in CPR, its beneficial effects have been challenged. The effectiveness of calcium chloride was evaluated and compared with epinephrine during successive episodes of electromechanical dissociation (EMD) after ventricular fibrillation in closed-chest dogs. Each of three successive episodes of CPR was randomly and blindly treated by repeated (every 2 min) injections of 5 ml H2O plus either 500 mg of calcium chloride (CaCl2), 1 mg of epinephrine (Epi), or 5% dextrose (D5W). Of 42 CPR attempts performed on 16 dogs, 16 were reversed by only chest compression and artificial ventilation. For the 26 CPR with pharmacologic intervention, recovery was obtained after one injection in 5 of 6 Epi but only in 4 of 11 CaCl2 and 4 of 9 D5W. Only four CPR attempts were ultimately unsuccessful, all in CaCl2 group. During recovery, the Epi group showed significantly higher arterial pressures and heart rates but less severe acidemia. In this model, calcium chloride alone is ineffective during EMD.

Acute ethanol intoxication in this model of peritonitis resulted in earlier development of shock and renal dysfunction but did not alter brain perfusion and metabolism or short-term survival.

CRP levels increase in the first week after major surgery but to a much larger extent in infected than in noninfected patients. Persistently high CRP levels after POD 4, especially when >100 mg/L, suggest the presence of a postoperative infection.