Krier C, Wiedemann K, Fleischer F, Jürs G, Hoyer S
Anasth Intensivther Notfallmed. 1987 Apr;22(2):56-62.
Cardiac arrest is followed by complete cerebral ischemia, which is characterized by delayed hypoperfusion and transient hypermetabolism. Brain metabolism depressant drugs, such as barbiturates, were suggested to improve neuronal outcome. The hypothesis of a cerebroprotective effect of barbiturates remained nevertheless controversial. In order to define the utility of large doses of thiopentone, the effect of thiopentone on carbohydrate and energy metabolism of 1-year old Wistar rats was investigated in an experimental model of complete reversible ischemia followed by a recovery period. No beneficial effect of high-dose thiopentone could be demonstrated by means of changes in the carbohydrate metabolism and the energyrich compounds. There were no differences between the treated group and the spontaneous recovery group. These results are mainly confirmed by other investigators. In contrast to focal ischemia and hypoxemia beneficial effects of barbiturates can not be demonstrated after complete cerebral ischemia in experimental studies and in clinical studies as well. In conclusion there is no indication for high-dose barbiturate therapy after cardiac arrest and successfull resuscitation.
心脏骤停后会出现全脑缺血，其特征为延迟性低灌注和短暂性高代谢。有人提出使用脑代谢抑制药物（如巴比妥类药物）来改善神经元预后。然而，巴比妥类药物具有脑保护作用这一假说仍存在争议。为了确定大剂量硫喷妥钠的效用，在一个完全可逆性缺血后接着是恢复期的实验模型中，研究了硫喷妥钠对1岁Wistar大鼠碳水化合物和能量代谢的影响。通过碳水化合物代谢和高能化合物的变化，未证实高剂量硫喷妥钠有有益作用。治疗组与自然恢复组之间没有差异。其他研究者也主要证实了这些结果。与局灶性缺血和低氧血症不同，在实验研究和临床研究中，全脑缺血后均未证实巴比妥类药物有有益作用。总之，心脏骤停并成功复苏后，没有迹象表明需要进行高剂量巴比妥类药物治疗。
