RESUMO
Adenosine antagonists may have therapeutic potential in cardiopulmonary resuscitation. Aminophylline, a widely available adenosine antagonist, is not included in the Guidelines for Advanced Life Support by the European Resuscitation Council or the American Heart Association. This report addresses a case of out-of-hospital cardiac arrest caused by inferior wall myocardial infarction in which effective circulation was restored subsequent to aminophylline administration, after prolonged conventional resuscitation had resulted in asystole.
Assuntos
Aminofilina/uso terapêutico , Reanimação Cardiopulmonar/métodos , Cardiotônicos/uso terapêutico , Parada Cardíaca/terapia , Idoso , Diabetes Mellitus Tipo 2/complicações , Eletrocardiografia , Feminino , Parada Cardíaca/etiologia , Humanos , Hipertensão/complicações , Infarto do Miocárdio/complicações , Infarto do Miocárdio/terapiaRESUMO
BACKGROUND: Newborn infants are particularly prone to hypothermia, a condition with a high mortality. OBJECTIVE: To study the CT brain patterns in infants with hypothermia and neurological symptoms. MATERIALS AND METHODS: We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma. RESULTS: Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia. CONCLUSIONS: The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause.