The three “H” strategy uses hypothermia, hemodilution and hypocalcemia to block the dying process; in other words, to prevent reperfusion injury from occurring during the subsequent resuscitation. This is followed by the normalization of the venous pCO2 and venous pH which reactivates the antioxidants. The normalization of the hematocrit (increased oxygenation) can then be performed. The calcium is then normalized and, finally, normothermia is restored. Continued extracorporeal support in the form of ECMO will probably be needed since no strategy can completely negate all the injury from reperfusion.
Perfusion Theory is an educational platform for the Oxygen Pressure Field Theory (OPFT). August Krogh’s theoretical concept of the oxygen pressure field is explained and then applied to clinical applications in perfusion practice.