НОВЫЕ АСПЕКТЫ РЕАНИМАТОЛОГИИ В НЕВРОЛОГИИ И НЕЙРОХИРУРГИИ
https://doi.org/10.15360/1813-9779-2014-6-55-64
Аннотация
Течение критических состояний в неврологии и нейрохирургии обладает особенностями, связанными со сложностью патогенеза церебрального повреждения, что, в свою очередь, обуславливает специфику реанимационной помощи. Для краткости изложения методы общей реаниматологии в неврологии и нейрохирургии целесообразно характеризовать термином нейрореаниматология. В статье освещены последние тенденции в проведении мультимодального мониторинга и специфической терапии в нейрореаниматологии. Кроме этого, приведены данные, показывающие исключительную важность осуществления инфекционного контроля при лечении пациентов неврологического и нейрохирургического профиля, находящихся в критическом состоянии.
Об авторах
К. А. ПопугаевРоссия
И. А. Савин
Россия
А. В. Ошоров
Россия
Список литературы
1. Avrushchenko M.Sh., Moroz V.V., Ostrova I.V. Postreanimatsionnye izmeneniya mozga na urovne neironalnykh populyatsii: zakonomernos ti i mekhanizmy. Obshchaya Reanimatologiya. [Postresuscitation changes in the brain at the level of neuronal populations: patterns and mechanisms. General Reanimatology]. 2012; 8 (4): 69–78. http://dx.doi.org/10.15360/181397792012469. [In Russ.]
2. Avrushchenko M.Sh., Zarzhetsky Yu.V., Moroz V.V., Ostrova I.V., Gudasheva T.A., Seredenin S.B. Vliyanie mimetika faktora rosta nervov GK2 na strukturnofunktsionalnoe sostoyanie mozga v rannem postreanimatsionnom periode (eksperimentalnoe issledovanie). Obshchaya Reanimatologiya. [Effect of the nerve growth factor mimetic GK2 on brain structural and functional state in the early postresus citation period. General Reanimatology]. 2012; 8 (5): 19–23. http://dx.doi.org/10.15360/181397792012519. [In Russ.]
3. Likhvantsev V.V., Grebenchikov O.A., Shaposhnikov A.A., Borisov K.Yu., Cherpakov R.A., Shulgina N.M. Farmakologicheskoe prekonditsionirovanie: rol opioidnykh peptidov. Obshchaya Reanimatologiya. [Pharmacological preconditioning: role of opioid peptides. General Reanimatology]. 2012; 8 (3): 51–55. http://dx.doi.org/10.15360/181397792012351. [In Russ.]
4. Likhvantsev V.V., Grebenchikov O.A., Plotnikov E.Yu., Borisov K.Yu., Shaibakova V.L., Shaposhnikov A.A., Cherpakov R.A., Shmeleva E.V. Mekhanizmy farmakologicheskogo prekonditsionirovaniya mozga i sravnitelnaya effektivnost preparatov – ingibitorov glikogensintetazy kinazy3 beta pryamogo i nepryamogo deistviya (eksperimentalnoe issledovanie). Obshchaya Reanimatologiya. [The mechanisms of arma cological preconditioning of the brain and the comparative efficacy of the drugs – direct and indirectacting glycogen synthase kinase3в ingibitors: experimental study. General Reanimatology]. 2012; 8 (6): 37–42. http://dx.doi.org/10.15360/181397792012637. [In Russ.]
5. Kramer A.H., Zygun D.A. Do neurocritical care units save lives? Measuring the impact of specialized ICUs. Neurocrit. Care. 2011; 14 (3): 329–333. http://dx.doi.org/10.1007/s120280119530y. PMID: 21424177
6. Knopf L., Staff I., Gomes J., McCullough L. Impact of a neurointensivist on outcomes in critically ill stroke patients. Neurocrit. Care. 2012; 16 (1): 63–71. http://dx.doi.org/10.1007/s120280119620x. PMID: 21847702
7. Teasdale G., Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974; 2 (7872): 81–84. PMID: 4136544 8. Teasdale G.M., Jennett B. Assessment and prognosis of coma after head injury. Acta Neurochir. (Wien). 1976; 34 (1—4): 45–55. http://dx.doi.org/10. 1007/BF01405862. PMID: 961490
8. Benzer A., Mitterschiffthaler G., Marosi M., Luef G., Pьhringer F., De La Renotiere K., Lehner H., Schmutzhard E. Prediction of nonsurvival after trauma: Innsbruck Coma Scale. Lancet. 1991; 338 (8773): 977–978. PMID: 1681344
9. Starmark J.E., Stalhammar D., Holmgren E. The Reaction Level Scale (RLS85). Manual and guidelines. Acta Neurochir. (Wien). 1988; 91 (1–2): 12–20. PMID: 3394542
10. Wijdicks E.F., Bamlet W.R., Maramattom B.V., Manno E.M., McClelland R.L. Validation of a new coma scale: The FOUR Score. Ann. Neurol. 2005; 58 (4): 585–593. http://dx.doi.org/10.1002/ana.20611. PMID: 16178024 12. Fugate J.E., Rabinstein A.A., Claassen D.O., White R.D., Wijdicks E.F. The FOUR score predicts outcome in patients after cardiac arrest. Neurocrit. Care. 2010; 13 (2): 205–210. http://dx.doi.org/10.1007/s1202801094075. PMID: 20645026
11. Sadaka F., Patel D., Lakshmanan R. The FOUR score predicts outcome in patients after traumatic brain injury. Neurocrit. Care. 2012; 16 (1): 95–101. http://dx.doi.org/10.1007/s1202801196175. PMID: 21845490
12. Stead L.G., Wijdicks E.F., Bhagra A., Kashyap R., Bellolio M.F., Nash D.L., Enduri S., Schears R., William B. Validation of a new coma scale, the FOUR score, in the emergency department. Neurocrit. Care. 2009; 10 (1): 50–54. http://dx.doi.org/10.1007/s1202800891450. PMID: 18807215
13. Stocchetti N., Roux P.L., Vespa P., Oddo M., Citerio G., Andrews P.J., Stevens R.D., Sharshar T., Taccone F.S., Vincent J.L. Clinical review: Neuromonitoring — an update. Crit. Care. 2013; 17 (1): 201. http://dx.doi.org/10.1186/cc11513. PMID: 23320763
14. Sivaganesan A., Manley G.T., Huang M.C. Informatics for neurocritical care: challenges and opportunities. Neurocrit. Care. 2014; 20 (1): 132–141. http://dx.doi.org/10.1007/s1202801398728. PMID: 23884510
15. Jaeger M., Dengl M., Meixensberger J., Schuhmann M.U. Effects of cere brovascular pressure reactivityguided optimization of cerebral perfu sion pressure on brain tissue oxygenation after traumatic brain injury. Crit. Care Med. 2010; 38 (5): 1343–1347. http://dx.doi.org/10.1097/ CCM.0b013e3181d45530. PMID: 20154598
16. Zweifel C., Lavinio A., Steiner L.A., Radolovich D., Smielewski P., Timofeev I., Hiler M., Balestreri M., Kirkpatrick P.J., Pickard J.D., Hutchinson P., Czosnyka M. Continuous monitoring of cerebrovascular pressure reactivity in patients with head injury. Neurosurg. Focus. 2008; 25 (4): E2. http://dx.doi.org/10.3171/FOC.2008.25.10.E2. PMID: 18828700
17. Vajda F.J. Neuroprotection and neurodegenerative disease. J. Clin. Neurosci. 2002; 9 (1): 4–8. PMID: 11749009
18. Karnatovskaia L.V., Wartenberg K.E., Freeman W.D. Therapeutic hypothermia for neuroprotection: history, mechanisms, risks, and clin ical applications. Neurohospitalist. 2014; 4 (3): 153. http://dx.doi.org/10.1177/1941874413519802.
19. O’Collins V.E., Macleod M.R., Donnan G.A., Horky L.L., van der Worp B.H., Howells D.W. 1,026 Experimental treatments in acute stroke. Ann. Neurol. 2006; 59 (3): 467–477. http://dx.doi.org/10.1002/ana.20741. PMID: 16453316
20. Kidwell C.S., Liebeskind D.S., Starkman S., Saver J.L.Trends in acute ischemic stroke trials through the 20th century. Stroke. 2001; 32 (6): 1349–1359. http://dx.doi.org/10.1161/01.STR.32.6.1349. PMID: 11387498
21. Pickard J.D., Murray G.D., Illingworth R., Shaw M.D., Teasdale G.M., Foy P.M., Humphrey P.R., Lang D.A., Nelson R., Richards P. Effect of oralnimodipine on cerebral infarction and outcome after subarachnoid haem orrhage: British aneurysm nimodipine trial. BMJ. 1989; 298 (6674): 636–642. http://dx.doi.org/10.1136/bmj.298.6674.636. PMID: 2496789
22. Kofke W.A. Incrementally applied multifaceted therapeutic bundles in neuroprotection clinical trials…time for change. Neurocrit. Care. 2010; 12 (3): 438–444. http://dx.doi.org/10.1007/s1202801093327.PMID: 20146027
23. Ortiz R., Lee K. Nosocomial infections in neurocritical care. Cur. Neurol. Neurosci. Rep. 2006; 6 (6): 525–530. http://dx.doi.org/10.1007/s1191000600561. PMID: 17074289
24. Chamorro A., Urra X., Planas A.M. Infection after acute ischemic stroke: a manifestation of braininduced immunodepression. Stroke. 2007; 38 (3): 1097–1103. http://dx.doi.org/10.1161/01.STR.0000258346.68966.9d.PMID: 17255542
25. Dziedzic T., Slowik A., Szczudlik A. Nosocomial infections and immunity: lesson from braininjured patients. Crit. Care. 2004; 8 (4): 266–270. PMID: 15312209
26. Meisel C., Schwab J.M., Prass K., Meisel A., Dirnagl U. Central nervoussystem injuryinduced immune deficiency syndrome. Nat. Rev. Neurosci. 2005; 6 (10): 775–786. http://dx.doi.org/10.1038/nrn1765. PMID: 16163382
27. Prass K., Meisel C., Hцflich C., Braun J., Halle E., Wolf T., Ruscher K., Victorov I.V., Priller J., Dirnagl U., Volk H.D., Meisel A. Strokeinduced immunodeficiency promotes spontaneous bacterial infections and is mediated by sympathetic activation reversal by poststroke T helper cell type 1like immunostimulation. J. Exp. Med. 2003; 198 (5): 725–736. http://dx.doi.org/10. 1084/jem.20021098. PMID: 12939340
28. Woiciechowsky C., Asadullah K., Nestler D., Eberhardt B., Platzer C., Schцning B., Glцckner F., Lanksch W.R., Volk H.D., Dцcke W.D. Sympathetic activation triggers systemic interleukin10 release in immunodepression induced by brain injury. Nat. Med. 1998; 4 (7): 808–813. http://dx.doi.org/10.1038/nm0798808. PMID: 9662372
29. Wong C.H., Jenne C.N., Lee W.Y., Leger C., Kubes P. Functional inner vation of hepatic iNKT cells is immunosuppressive following stroke. Science. 2011; 334 6052): 101–105. http://dx.doi.org/10.1126/science.1210301. PMID: 21921158
30. Muehlschlegel S., Carandang R., Ouillette C., Hall W., Anderson F., Goldberg R. Frequency and impact of intensive care unit complications on moderatesevere traumatic brain injury: early results of the Outcome Prognostication in Traumatic Brain Injury (OPTIMISM) Study. Neurocrit. Care. 2013; 18 (3): 318–331. http://dx.doi.org/10.1007/s1202801398172. PMID: 23377884
31. SchirmerMikalsen K., Moen K.G., Skandsen T., Vik A., Klepstad P. Intensive care and traumatic brain injury after the introduction of a treatment protocol: a prospective study. Acta Anaesthesiol. Scand. 2013; 57 (1): 46–55. http://dx.doi.org/10.1111/j.13996576.2012.02785.x. PMID: 23095138
32. Kourbeti I.S., Jacobs A.V., Koslow M., Karabetsos D., Holzman R.S. Risk fac tors associated with postcraniotomy meningitis. Neurosurgery. 2007; 60 (2): 317–325. http://dx.doi.org/10.1227/01.NEU.0000249266.26322.25. PMID: 17290182
33. Lozier A.P., Sciacca R.R., Romagnoli M.F., Connolly E.S.Jr. Ventriculostomyrelated infections: a critical review of the literature. Neurosurgery. 2008; 62 (Suppl 2): 688–700. http://dx.doi.org/10. 1227/01.neu.0000316273.35833.7c. PMID: 18596436
34. Stenehjem E., Armstrong W.S. Central nervous system device infections. Infect Dis. Clin. North Am. 2012; 26 (1): 89–110. http://dx.doi.org/10.1016/j.idc.2011.09.006. PMID: 22284378
35. Lyke K.E., Obasanjo O.O., Williams M.A., O’Brien M., Chotani R., Perl T.M. Ventriculitis complicating use of intraventricular catheters in adult neurosurgical patients. Clin. Infect. Dis. 2001; 33 (12): 2028–2033. http://dx.doi.org/10.1086/324492. PMID: 11712094
36. Mayhall C.G., Archer N.H., Lamb V.A., Spadora A.C., Baggett J.W.,Ward J.D., Narayan R.K. Ventriculostomyrelated infections. A prospective epidemio logic study. N. Engl. J. Med. 1984; 310 (9): 553–559. PMID: 6694707
37. Hoefnagel D., Dammers R., Ter LaakPoort M.P., Avezaat C.J. Risk factors for infections related to external ventricular drainage. Acta Neurochir. (Wien). 2008; 150 (3): 209–214.
38. http://dx.doi.org/10.1007/s0070100714589. PMID: 18278575
39. Chi H., Chang K.Y., Chang H.C., Chiu N.C., Huang F.Y. Infections associated with indwelling ventriculostomy catheters in a teaching hospital. Int. J. Infect. Dis. 2010; 14 (3): e216–e219. http://dx.doi.org/10.1016/j.ijid.2009.04.006. PMID: 19647466
40. Kourbeti I.S., Vakis A.F., Papadakis J.A., Karabetsos D.A., Bertsias G., Filippou M., Ioannou A., Neophytou C., Anastasaki M., Samonis G. Infections in traumatic brain injury patients. Clin. Microbiol. Infect. 2012; 18 (4): 359–364. http://dx.doi.org/10.1111/j.14690691.2011. 03625.x. PMID: 21851488
41. Westendorp W.F., Nederkoorn P.J., Vermeij J.D., Dijkgraaf M.G., van de Beek D. Poststroke infection: a systematic review and metaanalysis. BMC Neurol. 2011; 11: 110. http://dx.doi.org/10.1186/1471237711110. PMID: 21933425
42. Hall M.J., Williams S.N., DeFrances C.J., Golosinskiy A. Inpatient care for septicemia or sepsis: a challenge for patients and hospitals. NCHS Data Brief. 2011; 62: 1–8. PMID: 22142805
43. Iwashyna T.J., Ely E.W., Smith D.M., Langa K.M. Longterm cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010; 304 (16): 1787–1794. http://dx.doi.org/10.1001/jama. 2010.1553. PMID: 20978258
44. Gastmeier P. Evidencebased infection control in the ICU (except catheters). Curr. Opin. Crit. Care. 2007; 13 (5): 557–562. http://dx.doi.org/10. 1097/MCC.0b013e328288811a. PMID: 17762236
45. Inweregbu K., Dave J., Pittard A. Nosocomial infections. Continuing Education in Anaesthesia, Critical Care and Pain. 2005; 5 (1): 14–17. http://dx.doi.org/10.1093/bjaceaccp/mki006.
Рецензия
Для цитирования:
Попугаев К.А., Савин И.А., Ошоров А.В. НОВЫЕ АСПЕКТЫ РЕАНИМАТОЛОГИИ В НЕВРОЛОГИИ И НЕЙРОХИРУРГИИ. Общая реаниматология. 2014;10(6):55-64. https://doi.org/10.15360/1813-9779-2014-6-55-64
For citation:
Popugaev K.A., Savin I.A., Oshorov A.V. New Aspects of Resuscitation in Neurology and Neurosurgery. General Reanimatology. 2014;10(6):55-64. https://doi.org/10.15360/1813-9779-2014-6-55-64