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adenosine lidocaine magnesium

Geoffrey Phillip Dobson, Hayley Louise Letson
New frontline drugs and therapies are urgently required to protect the body from primary and secondary injuries. We review more than 10 years of work on adenosine, lidocaine, and magnesium (ALM) and its possible significance to civilian and military medicine. Adenosine is an endogenous nucleoside involved in nucleotide production, adenosine triphosphate turnover, and restoration of supply and demand imbalances. Lidocaine is a local anesthetic and Class 1B antiarrhythmic, and magnesium is essential for ionic regulation and cellular bioenergetics...
January 2016: Journal of Trauma and Acute Care Surgery
Hayley L Letson, Geoffrey P Dobson
BACKGROUND: Acute traumatic coagulopathy is a major contributor to mortality and morbidity following hemorrhagic shock. Our aim was to examine the effect of small-volume 7.5% NaCl with adenosine, lidocaine, and Mg (ALM) resuscitation on the timing of correction of coagulopathy in the rat model of severe hemorrhagic shock using ROTEM. METHODS: Male rats (300-450 g, n = 64) were randomly assigned to (1) baseline, (2) sham, (3) bleed, (4) shock, (5) 7.5% NaCl for 5 minutes, (6) 7...
April 2015: Journal of Trauma and Acute Care Surgery
Asger Granfeldt, Hayley L Letson, Geoffrey P Dobson, Wei Shi, Jakob Vinten-Johansen, Else Tønnesen
INTRODUCTION: The combination of Adenosine (A), lidocaine (L) and Mg(2+) (M) (ALM) has demonstrated cardioprotective and resuscitative properties in models of cardiac arrest and hemorrhagic shock. This study evaluates whether ALM also demonstrates organ protective properties in an endotoxemic porcine model. METHODS: Pigs (37 to 42 kg) were randomized into: 1) Control (n = 8) or 2) ALM (n = 8) followed by lipopolysaccharide infusion (1 μg ∙ kg(-1) ∙ h(-1)) for five hours...
2014: Critical Care: the Official Journal of the Critical Care Forum
Maddison J Griffin, Hayley L Letson, Geoffrey P Dobson
BACKGROUND: No drug therapy has demonstrated improved clinical outcomes in the treatment of sepsis. A bolus of adenosine, lidocaine, and magnesium (ALM) has been shown to be cardioprotective and restore coagulopathy in different trauma states. We hypothesized that ALM therapy may improve hemodynamics, protect the lung, and prevent coagulopathy in the rat sepsis model. METHODS: Nonheparinized, anesthetized Sprague-Dawley rats (350-450 g, n = 32) were randomly assigned to (1) shams (without sepsis), (2) saline controls, and (3) ALM treatment...
September 2014: Journal of Trauma and Acute Care Surgery
Annouk Perret Morisoli, Fabrizio Gronchi, Enrico Ferrari, Catherine Blanc, Philippe Frascarolo, Anne Angelillo-Scherrer, Carlo Marcucci
BACKGROUND: Multiple electrode aggregometry (MEA) is a point-of-care test evaluating platelet function and the efficacy of platelet inhibitors. In MEA, electrical impedance of whole blood is measured after addition of a platelet activator. Reduced impedance implies platelet dysfunction or the presence of platelet inhibitors. MEA plays an increasingly important role in the management of perioperative platelet dysfunction. In vitro, midazolam, propofol, lidocaine and magnesium have known antiplatelet effects and these may interfere with MEA interpretation...
September 2014: European Journal of Anaesthesiology
T K Nielsen, C L Hvas, G P Dobson, E Tønnesen, A Granfeldt
BACKGROUND: Hemorrhagic shock may trigger an inflammatory response and acute lung injury. The combination adenosine, lidocaine (AL) plus Mg(2+) (ALM) has organ-protective and anti-inflammatory properties with potential benefits in resuscitation.The aims of this study were to investigate: (1) pulmonary function and inflammation after hemorrhagic shock; (2) the effects of ALM/AL on pulmonary function and inflammation. METHODS: Pigs (38 kg) were randomized to: sham + saline (n = 5); sham + ALM/AL (n = 5); hemorrhage control (n = 11); and hemorrhage + ALM/AL (n = 9)...
September 2014: Acta Anaesthesiologica Scandinavica
Asger Granfeldt, Hayley L Letson, Janus A Hyldebrandt, Edward R Wang, Pablo A Salcedo, Torben K Nielsen, Else Tønnesen, Jakob Vinten-Johansen, Geoffrey P Dobson
OBJECTIVES: Currently, there is no effective small-volume fluid for traumatic hemorrhagic shock. Our objective was to translate small-volume 7.5% NaCl adenosine, lidocaine, and Mg hypotensive fluid resuscitation from the rat to the pig. DESIGN: Pigs (35-40 kg) were anesthetized and bled to mean arterial pressure of 35-40 mm Hg for 90 minutes, followed by 60 minutes of hypotensive resuscitation and infusion of shed blood. Data were collected continuously. SETTING: University hospital laboratory...
May 2014: Critical Care Medicine
Geoffrey P Dobson, Giuseppe Faggian, Francesco Onorati, Jakob Vinten-Johansen
Despite surgical proficiency and innovation driving low mortality rates in cardiac surgery, the disease severity, comorbidity rate, and operative procedural difficulty have increased. Today's cardiac surgery patient is older, has a "sicker" heart and often presents with multiple comorbidities; a scenario that was relatively rare 20 years ago. The global challenge has been to find new ways to make surgery safer for the patient and more predictable for the surgeon. A confounding factor that may influence clinical outcome is high K(+) cardioplegia...
2013: Frontiers in Physiology
Yulia Djabir, Hayley L Letson, Geoffrey P Dobson
INTRODUCTION: No drug therapy has demonstrated improved survival following cardiac arrest (CA) of cardiac or noncardiac origin. In an effort to translate the cardiorescue properties of Adenocaine (adenosine and lidocaine) and magnesium sulfate (ALM) from cardiac surgery and hemorrhagic shock to resuscitation, we examined the effect of ALM on hemodynamic rescue and coagulopathy following asphyxial-induced CA in the rat. METHODS: Nonheparinized animals (400-500 g, n = 39) were randomly assigned to 0...
September 2013: Shock
Robert M Van Haren, Kenneth G Proctor
No abstract text is available yet for this article.
November 2012: Critical Care Medicine
Asger Granfeldt, Torben K Nielsen, Christoffer Sølling, Janus A Hyldebrandt, Jørgen Frøkiær, Lise Wogensen, Geoffrey P Dobson, Jakob Vinten-Johansen, Else Tønnesen
OBJECTIVES: Hypotensive resuscitation is gaining clinical acceptance in the treatment of hemorrhagic shock. Our aims were to investigate: 1) the effect of 7.5% NaCl with adenocaine (adenosine and lidocaine, AL) and AL with Mg (ALM) on fluid requirement to maintain a minimum mean arterial pressure of 50 mm Hg, and 2) the effect of a second bolus of 0.9% NaCl with AL during return of shed blood on cardiac and renal function in a porcine model of hemorrhagic shock. DESIGN: Pigs were randomized to: Sham (n = 5), Sham + ALM/AL (n = 5), hemorrhage control (n = 11), or hemorrhage + ALM/AL (n = 9)...
November 2012: Critical Care Medicine
Sandro B Rizoli, Bartolomeu Nascimento
No abstract text is available yet for this article.
August 2012: Critical Care Medicine
Hayley L Letson, Natalie M Pecheniuk, Lebo P Mhango, Geoffrey P Dobson
OBJECTIVE: Acute traumatic coagulopathy occurs early in hemorrhagic trauma and is a major contributor to mortality and morbidity. Our aim was to examine the effect of small-volume 7.5% NaCl adenocaine (adenosine and lidocaine, adenocaine) and Mg on hypotensive resuscitation and coagulopathy in the rat model of severe hemorrhagic shock. DESIGN: Prospective randomized laboratory investigation. SUBJECTS: A total of 68 male Sprague Dawley Rats...
August 2012: Critical Care Medicine
Hayley L Letson, Geoffrey P Dobson
Hemorrhage is responsible for up to 40% of trauma mortality, and of these deaths, 33% to 56% occur during the prehospital period. In an effort to translate the cardioprotective effects of Adenocaine (adenosine, lidocaine) and Mg (ALM) from cardiac surgery to resuscitation science, we examined the early resuscitative effects of 7.5% NaCl with ALM in the rat model of 60% blood loss. Male Sprague-Dawley rats (250-350 g, n = 40) were anesthetized and randomly assigned to one of five groups: (a) untreated, (b) 7...
December 2011: Shock
Hayley L Letson, Geoffrey P Dobson
OBJECTIVE: Much controversy exists over the fluid composition for hypotensive resuscitation. We previously showed that addition of 6% Dextran-70 or hetastarch to 7.5% NaCl led to heart instability and mortality. Our aim was to examine the early resuscitative effects of 7.5% NaCl with adenosine, lidocaine, and magnesium (ALM) on hemodynamics and mortality in a rat model of severe hemorrhagic shock. METHODS: Male fed Sprague-Dawley rats (300-450 g, n = 48) were anesthetized and randomly assigned to one of six groups (n = 8): (1) Untreated, (2) 7...
September 2011: Journal of Trauma
James J O'Rullian, Stephen E Clayson, Raul Peragallo
A 71-year-old high-risk fourth-time redo male patient was diagnosed with prosthetic valve endocarditis of both aortic and mitral valves, and subsequently required a re-operative aortic and mitral valve replacement. He was placed on cardiopulmonary bypass (CPB) and arrested with normothermic hyperkalemic all-blood cardioplegia (microplegia) containing adjunctive adenosine-lidocaine-magnesium (adenocaine); aerobic arrest was maintained with near-continuous retrograde low potassium (approximately 2 mEq/L) adenocaine microplegia...
September 2008: Journal of Extra-corporeal Technology
Geoffrey P Dobson, Michael W Jones
OBJECTIVE: Depolarizing potassium cardioplegia has been increasingly linked to left ventricular dysfunction, arrhythmia, and microvascular damage. We tested a new polarizing normokalemic cardioplegic solution employing adenosine and lidocaine as the arresting, protecting, and preserving cardioprotective combination. Adenosine hyperpolarizes the myocyte by A1 receptor activation, and lidocaine blocks the sodium fast channels. METHODS: Isolated perfused rat hearts were switched from the working mode to the Langendorff (nonworking) mode and arrested for 30 minutes, 2 hours, or 4 hours with 200 micromol/L adenosine and 500 micromol/L lidocaine in Krebs-Henseleit buffer (10 mmol/L glucose, pH 7...
March 2004: Journal of Thoracic and Cardiovascular Surgery
Andrea Sarkozy, Paul Dorian
Safe and effective control of rapid ventricular rates in acute-onset atrial fibrillation (AF) can be accomplished with intravenous calcium antagonists, beta-blockers or amiodarone; digoxin is less effective. If pharmacologic cardioversion of AF is desired, single oral doses of propafenone or flecainide are safe and effective in patients without structural heart disease. Intravenous ibulitide is moderately effective in the conversion of persistent AF or atrial flutter, with a small risk of proarrhythmia. In wide QRS complex tachycardia of uncertain origin, adenosine and lidocaine are no longer recommended...
September 2003: Current Cardiology Reports
J X Liu, K Tanonaka, Y Ohtsuka, Y Sakai, S Takeo
The present study was undertaken to determine whether class Ic antiarrhythmic agents, flecainide and pilsicainide, improve ischemia/reperfusion-induced cardiac contractile dysfunction. Isolated rat hearts were subjected to a 35-min global ischemia, followed by a 60-min reperfusion, and the functional and metabolic consequences were examined. Ischemia/reperfusion resulted in no recovery of contractile function and a sustained rise in left ventricular and diastolic pressure of the perfused heart during reperfusion...
September 1993: Journal of Pharmacology and Experimental Therapeutics
T R Delbridge, D M Yealy
Wide complex tachycardias present diagnostic challenges for emergency physicians. The history, physical examination, and ECG provide information required to arrive at the correct diagnosis. When a previous history of heart disease exists, VT should be suspected; however, no single clinical feature is sufficiently reliable for distinguishing VT from SVT. Patients with VT may tolerate their dysrhythmias for several hours and maintain hemodynamic stability. ECG analysis is the most useful process in differentiating SVT and VT...
November 1995: Emergency Medicine Clinics of North America
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