Schneider Andreas, Böttiger Bernd W, Popp Erik
Department of Anesthesiology and Postoperative Intensive Care Medicine, University of Cologne, Kerpener Strasse 62, 50937 Köln, Germany.
Anesth Analg. 2009 Mar;108(3):971-9. doi: 10.1213/ane.0b013e318193ca99.
Cardiopulmonary resuscitation can restore spontaneous circulation in up to 50% of patients suffering from cardiac arrest. However, most of these patients still die during the postresuscitation period. Mortality is largely due to neuronal injury after global cerebral ischemia. There is, therefore, a clear need for therapies, which restore and protect brain function after cardiac arrest. Several years ago, mild therapeutic hypothermia was introduced into clinical practice. It represents the first treatment to improve both survival and neurological outcome of patients after out-of-hospital cardiac arrest, according to randomized clinical trials. In addition to therapeutic hypothermia, various other therapeutic options are currently being investigated experimentally and/or clinically. These include thrombolytic therapy, specific infusion regimens, or antiapoptotic drugs. In this article, we review both the pathophysiological background and the efficacy of different measures that might be useful for cerebral resuscitation.
心肺复苏术能使多达50%的心脏骤停患者恢复自主循环。然而，这些患者中的大多数仍在复苏后时期死亡。死亡率主要归因于全脑缺血后的神经元损伤。因此，显然需要在心脏骤停后恢复和保护脑功能的治疗方法。几年前，轻度治疗性低温被引入临床实践。根据随机临床试验，它是第一种能改善院外心脏骤停患者生存率和神经功能结局的治疗方法。除了治疗性低温外，目前还有各种其他治疗选择正在进行实验研究和/或临床研究。这些包括溶栓治疗、特定的输注方案或抗凋亡药物。在本文中，我们综述了可能对脑复苏有用的不同措施的病理生理背景和疗效。
