Attenuation of neurologic injury during cardiac surgery
Attenuation of neurologic injury during cardiac surgery
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DOI：
10.1016/s0003-4975(01)03258-1
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发表时间：
2001-11-01
影响因子：
4.6
通讯作者：
Murkin, JM
中科院分区：
文献类型：
--
作者：
Murkin, JM
心脏手术后的神经损伤可分为I型，包括临床明显的中风、癫痫性昏迷或昏迷，以及发生率更高的II型损伤，包括智力退化、记忆缺陷或癫痫发作。在许多此类病例中，脑栓塞显然是病因性的，并且正在引入几种新的主动脉插管，旨在捕获或转移潜在的脑栓塞。目前尚无结果数据。几种潜在的脑保护药物疗法，包括硫喷妥钠、异丙酚和尼莫地平，已经在临床上进行了评估，但总体而言，结果很差。对北美大型前瞻性、随机、安慰剂对照临床试验抑酶蛋白数据库的荟萃分析表明，大剂量抑酶蛋白具有脑保护潜力。(C) 2001年由胸外科医生协会。
Neurologic injury after cardiac surgery can be divided into type I, including clinically apparent stroke, seizures stupor, or coma, and much more occurring type II injury, including intellectual deterioration, memory deficit, or seizures. Cerebral embolization is demonstrably etiologic in many such cases, and several new aortic cannulas are being introduced that are aimed at capturing or diverting potential cerebral emboli. No outcome data are yet available. Several potentially cerebroprotective pharmacologic therapies including thiopental, propofol, and nimodipine, have been assessed clinically but, generally, the results have been poor. Meta-analysis of the large North American aprotinin database of prospective, randomized, placebo-controlled clinical trials is suggestive of a cerebroprotective potential associated with high-dose aprotinin administration. (C) 2001 by The Society of Thoracic Surgeons.