The drug Dantrolene sodium holds the most promise for dealing with calcium stress. It is added to the prime in the ECPR pump. Dantrolene is an FDA approved drug best known as a treatment for malignant hyperthermia (MH) and its variants. After the widespread introduction of Dantrolene, the mortality from malignant hyperthermia fell from 90% to less than 10%. MH patients commonly receive repeated doses of Dantrolene during their resuscitation. In addition, patients experiencing MH commonly receive infusions of ice cold normal saline to prevent any temperature elevation and to keep their blood potassium low. In spite of this, some MH patients experience cardiac arrest due to the greatly elevated blood potassium levels caused by muscle breakdown from MH and require CPR. Unlike other types of cardiac arrest patients whose survival is doubtful after 30 minutes of CPR, extended CPR for up to two hours in MH patients frequently has successful outcomes. This is probably because the MH resuscitation strategy using hypothermia, hemodilution and Dantrolene protects the MH patient from reperfusion injury. This same type of resuscitation strategy would benefit non-MH patients needing CPR resuscitation and/or ECPR.
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.