Use of pentoxifylline for patients in the postcardiac arrest status

Background Postcardiac arrest syndrome has a unique pathophysiological process involving multiple organs. Pentoxifylline can modulate infl ammation, oxidative stress, and endothelial function, and may thus reduce multiple organ dysfunction in postcardiac arrest patients and affect the outcome. The aim of this study was to evaluate the effect of intravenous pentoxifylline on organ functions and outcome in postcardiac arrest patients. Materials and methods Forty-two patients admitted to the ICU after inhospital cardiac arrest of both cardiac and noncardiac origin were included in this prospective double-blinded randomized two parallelgroup study. Group P received a fi rst dose of intravenous pentoxifylline 5 mg/kg over 5 min, followed by a 1.5 mg/kg/day infusion with a maximum of 1800 mg/day for 3 days, whereas group C received an equal volume of saline over 5 min and then infusion for 3 days as well.The primary outcome was the number of organ dysfunction-free and organ failure-free days,where as the secondary outcome included time to initial acceptable blood pressure and systemic perfusion, number of acceptable blood pressure and systemic perfusion days, arterial lactate, Cerebral Performance Category score, duration of inotropic support, duration of mechanical ventilation, length of ICU stay, ICU survival, and adverse events. Results There was a signifi cant increase in the number of organ dysfunction-free days [9 (3) vs. 6 (3), P = 0.003] and organ failure-free days [9 (3) vs. 7 (3), P = 0.008], accompanied by an increased number of acceptable blood pressure and systemic perfusion days [8 (3) vs. 6 (4), P = 0.01], with a shorter time to reach initial acceptable blood pressure and systemic perfusion [68 (51) vs. 38 (36), P = 0.03 ] and a signifi cant improvement in the Cerebral Performance Category score on days 6, 7, and 14 in group P compared with group C. The arterial lactate level, duration of mechanical ventilation, duration of inotropic support, and ICU length of stay were signifi cantly reduced in group P, along with an improvement in ICU survival that did not reach statistical signifi cance.Conclusion We conclude that administration of intravenous pentoxifylline in postcardiac arrest patientsi mproved organ function and decreased length of ICU stay, with no adverse effects.