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Treatment and Prognosis After Hypoxic-Ischemic Injury
- Source :
- Current Treatment Options in Neurology. 23
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- This review summarizes current and emerging treatments for hypoxic-ischemic brain injury (HIBI). Guidance on neuroprognostication after HIBI is also presented. After two 2002 studies demonstrated cooling improved neurologic outcome after HIBI, a 2013 trial found targeting 36 °C was non-inferior to targeting 33 °C. Research is ongoing, but there is no other definitive human data on therapies to prevent secondary brain injury after HIBI. Guideline-recommended treatment of HIBI includes early, optimal cardiopulmonary resuscitation to prevent primary brain injury, and targeted temperature management to mitigate secondary brain injury. Multiple novel treatment options, including anti-inflammatory agents, anesthetics, and neuroprotective cocktails, are currently being investigated. Additionally, neurostimulants may help promote wakefulness after HIBI. Neuroprognostication after HIBI requires a multimodal approach using the neurologic exam, electroencephalography, somatosensory evoked potentials, neuroimaging, and serum biomarkers. It is important to avoid premature prognostication and nihilism.
- Subjects :
- medicine.medical_specialty
Neurology
medicine.diagnostic_test
business.industry
medicine.medical_treatment
Multimodal therapy
Targeted temperature management
Electroencephalography
Neuroprotection
Somatosensory evoked potential
Anesthesia
medicine
Wakefulness
Neurology (clinical)
Cardiopulmonary resuscitation
business
Subjects
Details
- ISSN :
- 15343138 and 10928480
- Volume :
- 23
- Database :
- OpenAIRE
- Journal :
- Current Treatment Options in Neurology
- Accession number :
- edsair.doi...........908fce182034c76c8109fe1c35d23360