Reperfusion protection in resuscitation
An apparatus and method for resuscitating a patient suffering from cardiac arrest or another condition in which normal circulation has been interrupted. A ventilator is used for delivering a gas mixture to the patient. The ventilator is configured to adjust the partial pressure of CO2 to one or more partial pressures high enough to slow expiration of CO2 from the patient's lungs and thereby maintain a reduced pH in the patient's tissues for a period of time following return of spontaneous circulation.
1. Apparatus for resuscitating a patient suffering from cardiac arrest or another condition in which normal circulation has been interrupted, the apparatus comprising:
a ventilator for applying to the patient;
the ventilator being configured to deliver a gas mixture to the patient,
wherein the ventilator comprises at least one first sensor, associated processing, and memory configured to measure CO 2 concentration in an airway of the patient and, based on a comparison of at least two measurements of CO 2 concentration in the airway, determine that return of spontaneous circulation (ROSC) has occurred,
wherein the processor and the associated memory are further configured so that after the determination of the return of spontaneous circulation, the partial pressure of CO 2 is automatically adjusted to one or more partial pressures high enough to slow expiration of CO 2 from the patient's lungs and thereby maintain a reduced pH in the patient's tissues for an automatically determined period of time following the determination of the return of spontaneous circulation (ROSC), and
wherein the processor is configured to adjust the partial pressure of CO2 to be higher than ambient CO2 partial pressure during the automatically determined period of time.
2. The apparatus of claim 1 wherein adjustment of the partial pressure of CO 2 includes adding CO 2 to the gas inspired by the patient.
3. The apparatus of claim 1 wherein adjustment of the partial pressure of CO 2 has an effect of maintaining the pH of the patient's tissues below 7.0 for the period of time following the return of spontaneous circulation.
4. The apparatus of claim 1 further comprising a second sensor and associated processing for determining the pH of the patient's tissue, and automatically adjusting the partial pressure of CO 2 at least in part in response to the pH of the patient's tissue.