Electric countershock and cold stress effects on liver and adrenal gland

OBJECTIVES: Cold exposure induces glycogen and lipid depletion in the liver and the adrenal gland, respectively. However, no previous study has determined the effects of electrical countershock on those tissues. We aimed to evaluate the effects of electrical countershock on lipid depletion in the adrenal gland and on glycogen depletion in the liver. METHODS: We used 40 male Wistar rats divided into four groups: the control group, in which the animals were subjected to a resting period of seven days; the electrical discharge group, in which the animals were subjected to a resting period followed by administration of ten 300-mV electrical discharges; the electrical post-discharge group, in which the animals received ten electrical shocks (300 mV) followed by rest for seven consecutive days; and the cold stress group, in which the animals were subjected to a resting period and were then exposed to -8ºC temperatures for four hours. All animals underwent a laparotomy after treatment. The lipid and glycogen depletions are presented using intensity levels (where + = low intensity and ++++ = high intensity, with intermediate levels in between). RESULTS: The rats exposed to the cold stress presented the highest glycogen and lipid depletion in the liver and the adrenal gland, respectively. Furthermore, we noted that the electrical countershock significantly increased lipid depletion in the adrenal gland and glycogen depletion in the liver. One week after the electrical countershock, the liver and adrenal gland profiles were similar to that of the control group. CONCLUSION: Electrical countershock immediately increased the glycogen depletion in the liver and the lipid depletion in the adrenal gland of rats.

Advanced Cardiac Life Support for Hyperkalemic Cardiac Arrest

The acceptable total number of electrical shocks used in treating cardiac arrest is not exactly defined in any of the literature. It is generally expressed as "the more trials the less chance". Electrical therapy should be promptly performed in the presence of "shockable"rhythm. But for pulseless patients bystander cardiopulmonary resuscitation (CPR) should be done on instead. The most reasonable number of attempts of electrical therapy and the length of CPR or unresponsive ventricular fibrillation or pulseless ventricular tachycardia are not well defined. We report the case of 57-year-old woman presenting with mental change due to sustained pulseless ventricular tachycardia who survived to hospital discharge without neurological sequelae after 45 defibrillations and prolonged CPR for 86 minutes.