大脑输液和神经监测在复杂的大动脉门手术:一个叙事审查
Andrea Montisci1, Giulia Maj2, Corrado Cavozza3
1Division of Cardiothoracic Intensive Care, Cardiothoracic Department, ASST Spedali Civili, 25123 Brescia, Italy.
Journal of clinical medicine
|May 27, 2023
概括
在复杂的大动脉手术期间保护大脑包括管理血栓和低输血等风险. 低温和脑输液等策略可以尽量减少手术内脑损伤.
科学领域:
- 心血管外科心血管外科
- 神经外科 神经外科
- 麻醉学 麻醉学
背景情况:
- 复杂的大动脉手术需要大脑保护策略,以防止手术内大脑损伤.
- 循环停止期间的大脑损伤是多因素的,包括栓塞,低 perfusion,缺氧和炎症.
研究的目的:
- 描述大动脉手术中脑损伤的病理生理学.
- 分析和批判性审查大脑保护策略,包括低温和脑 perfusion 技术.
- 讨论当前的手术内大脑监测系统.
主要方法:
- 这是一个叙事评论.
- 在大动脉门手术期间对大脑保护的文献搜索.
- 低温和脑 perfusion 技术 (前进和逆向) 的分析.
主要成果:
- 大动脉手术期间的大脑损伤是复杂的和多因素的.
- 低温会减少大脑的氧气消耗,耐受循环停止.
- 前向性和后向性脑输液技术的目的是防止低温期间缺血.
结论:
- 有效的大脑保护策略对于复杂的大动脉手术至关重要.
- 低温和各种脑 perfusion 方法提供了明显的优势和局限性.
- 在手术期间对大脑进行监测,在评估大脑保护的有效性方面起着至关重要的作用.
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