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Verfasst von:Hertle, Daniel [VerfasserIn]   i
 Diedler, Jennifer [VerfasserIn]   i
 Veltkamp, Roland [VerfasserIn]   i
 Bruckner, Thomas [VerfasserIn]   i
 Unterberg, Andreas [VerfasserIn]   i
 Sakowitz, Oliver [VerfasserIn]   i
Titel:Effect of analgesics and sedatives on the occurrence of spreading depolarizations accompanying acute brain injury
Verf.angabe:Daniel N. Hertle, Jens P. Dreier, Johannes Woitzik, Jed A. Hartings, Ross Bullock, David O. Okonkwo, Lori A. Shutter, Steven Vidgeon, Anthony J. Strong, Christina Kowoll, Christian Dohmen, Jennifer Diedler, Roland Veltkamp, Thomas Bruckner, Andreas W. Unterberg, Oliver W. Sakowitz
Jahr:2012
Umfang:9 S.
Fussnoten:Published: 18 June 2012 ; Gesehen am 12.06.2018
Titel Quelle:Enthalten in: Brain
Ort Quelle:Oxford : Oxford Univ. Press, 1878
Jahr Quelle:2012
Band/Heft Quelle:135(2012), 8, Seite 2390-2398
ISSN Quelle:1460-2156
Abstract:Spreading depolarizations are waves of mass neuronal and glial depolarization that propagate across the injured human cortex. They can occur with depression of neuronal activity as spreading depressions or isoelectric spreading depolarizations on a background of absent or minimal electroencephalogram activity. Spreading depolarizations are characterized by the loss of neuronal ion homeostasis and are believed to damage functional neurons, leading to neuronal necrosis or neurological degeneration and poor outcome. Analgesics and sedatives influence activity-dependent neuronal ion homeostasis and therefore represent potential modulators of spreading depolarizations. In this exploratory retrospective international multicentre analysis, we investigated the influence of midazolam, propofol, fentanyl, sufentanil, ketamine and morphine on the occurrence of spreading depolarizations in 115 brain-injured patients. A surface electrode strip was placed on the cortex, and continuous electrocorticographical recordings were obtained. We used multivariable binary logistic regression to quantify associations between the investigated drugs and the hours of electrocorticographical recordings with and without spreading depolarizations or clusters of spreading depolarizations. We found that administration of ketamine was associated with a reduction of spreading depolarizations and spreading depolarization clusters (P < 0.05). Midazolam anaesthesia, in contrast, was associated with an increased number of spreading depolarization clusters (P < 0.05). By using a univariate odds ratio analysis, we also found a significant association between ketamine administration and reduced occurrence of isoelectric spreading depolarizations in patients suffering from traumatic brain injury, subarachnoid haemorrhage and malignant hemispheric stroke (P < 0.05). Our findings suggest that ketamine—or another N-methyl-d-aspartate receptor antagonist—may represent a viable treatment for patients at risk for spreading depolarizations. This hypothesis will be tested in a prospective study.
DOI:doi:10.1093/brain/aws152
URL:Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.

kostenfrei: Volltext: http://dx.doi.org/10.1093/brain/aws152
 kostenfrei: Volltext: https://academic.oup.com/brain/article/135/8/2390/304976
 DOI: https://doi.org/10.1093/brain/aws152
Datenträger:Online-Ressource
Sprache:eng
K10plus-PPN:1576281035
Verknüpfungen:→ Zeitschrift

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