Becker, Lance

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2009 - 200912010 - 20151
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  • Publication
    Persistently Altered Brain Mitochondrial Bioenergetics After Apparently Successful Resuscitation From Cardiac Arrest
    (2015-09-14) Kilbaugh, Todd; Sutton, Robert M; Karlsson, Michael; Hansson, Magnus J; Nadkarni, Vinay; Naim, Maryam Y; Becker, Lance; Morgan, Ryan W; Margulies, Susan S; Bratinov, George; Lampe, Joshua Willard; Berg, Robert A
    Background Although advances in cardiopulmonary resuscitation have improved survival from cardiac arrest (CA), neurologic injury persists and impaired mitochondrial bioenergetics may be critical for targeted neuroresuscitation. The authors sought to determine if excellent cardiopulmonary resuscitation and postresuscitation care and good traditional survival rates result in persistently disordered cerebral mitochondrial bioenergetics in a porcine pediatric model of asphyxia‐associated ventricular fibrillation CA. Methods and Results After 7 minutes of asphyxia, followed by ventricular fibrillation, 5 female 1‐month‐old swine (4 sham) received blood pressure–targeted care: titration of compression depth to systolic blood pressure of 90 mm Hg and vasopressor administration to a coronary perfusion pressure >20 mm Hg. All animals received protocol‐based vasopressor support after return of spontaneous circulation for 4 hours before they were killed. The primary outcome was integrated mitochondrial electron transport system (ETS) function. CA animals displayed significantly decreased maximal, coupled oxidative phosphorylating respiration (OXPHOSCI+CII) in cortex (PPPPCI PCII PCIPCII PCI+CII), as well as a 30% reduction in citrate synthase activity (P<0.04). Conclusions Mitochondria in both the cortex and hippocampus displayed significant alterations in respiratory function after CA despite excellent cardiopulmonary resuscitation and postresuscitation care in asphyxia‐associated ventricular fibrillation CA. Analysis of integrated ETS function identifies mitochondrial bioenergetic failure as a target for goal‐directed neuroresuscitation after CA. IACUC Protocol: IAC 13‐001023.
  • Publication
    Collaborative SCA Survival Project: Cardiac Arrest Survival is a Mess
    (2009-02-01) Starr, Larry M; Pourdehnad, John; Braslow, Allan; Poliafico, Frank; Abella, Benjamin; Nadkarni, Vinay; Becker, Lance; Merchant, Raina; Brennan, Robert
    Systems diagnoses have been effectively used to understand many complex organizational systems within healthcare, government, military, and global corporate enterprises. Systems methodologies have been effectively used to change the direction and improve the outcomes of complex organizational systems. We feel that framing cardiac arrest survival as a systems problem and applying a systems methodology is innovative, practical, and essential if we are to make significant and sustainable impact.