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Resuscitation is the act of restoring core, life-sustaining processes in a person who is dead or dying.
Even more fundamentally, each of these processes can be traced back to a single molecule:
If homeostasis is the basis of life, energy is the currency of homeostasis.
When we eat, our bodies take in macromolecules, break them into their smallest repeating units, and — through a network of enzyme-mediated reactions — produce so-called coenzymes.
These coenzymes act as electron donors, creating a charge gradient. The resultant potential energy is converted into chemical energy, where it drives the processes that keep us alive.
But this electrochemical gradient depends on oxygen.
And unfortunately, there isn't always enough of it to go around.
Oxygenation is a process, not an event.
It's a balance between oxygen consumption (VO2) and oxygen delivery (DO2).
When consumption exceeds supply, we call the resultant state "hypoxia". And if hypoxia is severe enough, it can cause permanent organ damage within minutes.
Some strategies to address this include:
There are many others, but no matter the approach, we can use endpoints to measure effectiveness.
When resuscitation works, the body returns to “normal”.
As part of this normality, certain downstream factors also return to their regular ranges.
So, by measuring these downstream factors (known as “endpoints”), we can get an idea of whether a patient has stabilised.
Some common endpoints are:
No single endpoint is conclusive, but they combine to form a clinical picture.
Next, let’s take a look at respiratory physiology in more detail.