Use of ATP following shock and ischemia.

The available information indicates that shock and ischemia are associated with such phenomena as diminished microcirculatory blood flow and diminished metabolic (including ATP levels) and cellular capabilities, and that these phenomena are associated with altered cellular functions. Infusion of ATP-MgCl2 as an adjunct following shock or ischemia significantly improves microcirculatory blood flow, tissue and mitochondrial magnesium levels, tissue ATP levels, cellular functions, and overall survival of animals. Administration of ATP or MgCl2 alone after such conditions was ineffective in improving cellular functions or the survival of animals. Thus, it could be concluded that ATP together with MgCl2 is required for an effective treatment. ATP-MgCl2 can be administered safely in normal volunteers as well as in patients following various adverse circulatory conditions. Administration of this agent in humans produces positive inotropic, negative chronotropic, and peripheral vasodilatory actions, which clearly suggests the potential use of this agent in patients with low-flow conditions or organ ischemia. Clinical trials of ATP-MgCl2 treatment in patients with various adverse circulatory conditions are underway at several institutions in this country as well as in Japan.