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Friday, February 26, 2016

Neuroprotection in acute brain injury

Resultado de imagen de Critical care CC journal
Nino Stocchetti N et al. Critical Care 2015; 19:186 - DOI: 10.1186/s13054-015-0887-8 
"Neuroprotective strategies that limit secondary tissue loss and/or improve functional outcomes have been identified in multiple animal models of ischemic, hemorrhagic, traumatic and nontraumatic cerebral lesions. However, use of these potential interventions in human randomized controlled studies has generally given disappointing results. In this paper, we summarize the current status in terms of neuroprotective strategies, both in the immediate and later stages of acute brain injury in adults. We also review potential new strategies and highlight areas for future research"

Fig 1. Neuroprotective strategies in the ICU. To avoid further insults to the brain (NMR image of a normal brain at the center), the goals of intensive care management are to ensure adequate oxygen delivery and to avoid excessive oxygen consumption, as in epileptic crises and cases of high brain temperature. See text for details on reperfusion after ischemic stroke, optimal hemoglobin level, and desirable cerebral perfusion pressure (CPP) levels. ICP, intracranial pressure; MAP, mean arterial pressure; PaO2, arterial oxygen tension.