Physiology of resuscitation.

Ischemia ultimately leads to loss of thermodynamic order in all cells. During ischemia and reperfusion, the influx of Ca2+ ions appears to initiate a number of cell processes, the reversal of which depends on the re-establishment and maintenance of adequate organ perfusion and high energy metabolism. Promising therapeutic approaches for accomplishing these goals include substrate augmentation, inhibition of calcium-activated injury, membrane stabilization, manipulation of the cycloxygenase and lipoxygenase reactions, and the use of free radical scavengers.