Interpretation of 2020 expert consensus statement on neuroprotection after cardiac arrest in China (Ⅲ): drug therapy

doi:10.11817/j.issn.1673-9248.2021.06.001

Abstract

Abstract:

Neuroprotection is one of the key measures for successful cardiopulmonary resuscitation with good prognosis for patients with cardiac arrest (CA). Although the success rate of cardiopulmonary resuscitation has increased, the prognosis of patients with CA after cardiopulmonary resuscitation has not been significantly improved due to insufficient follow-up treatment of cardiopulmonary resuscitation. In order to reduce brain damage and improve the survival and neurological prognosis of patients with CA, we interpreted the part of drug treatment in 2020 experts consensus statement on neuroprotection after CA in China, which mainly involved the treatments of brain protection and drug therapy selection .

Key words: Cardiac arrest, Cardiopulmonary resuscitation, Drug therapy, Neuroprotection, Consensus statement

Zhenzhong Li, Liqun Feng, Qingbian Ma, Tao Wang, Yongqiu Li, Bin Zhao, Xiuchuan Qin, Qingxi Li, Shizheng Wu, Hongbin Sun, Jun Yuan, Lan Chu, Jian Wu, Yuxiang Gu, Jimao Peng, Zhi Chen, Dongsheng Fan. Interpretation of 2020 expert consensus statement on neuroprotection after cardiac arrest in China (Ⅲ): drug therapy[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2021, 15(06): 356-360.

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URL: https://zhnxgbzz.cma-cmc.com.cn/EN/10.11817/j.issn.1673-9248.2021.06.001

https://zhnxgbzz.cma-cmc.com.cn/EN/Y2021/V15/I06/356

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References 31

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脑保护药物类型	常见药物	作用
丁苯酞	丁苯酞	（1）提高线粒体ATP酶及复合酶Ⅳ活性，保护线粒体膜结构和功能的完整，改善能量代谢；（2）提高脑细胞ATP水平和利用率，减轻脑损伤；（3）改善缺血区微循环，促进脑血流量恢复；（4）抗自由基作用，促进脑缺血患者神经功能的恢复；（5）抗炎、抗凋亡作用；（6）改善神经系统预后
自由基清除剂	依达拉奉	（1）抑制黄嘌呤氧化酶和次黄嘌呤氧化酶的活性，刺激前列环素的生成，减少白三烯的产生，降低脑缺血后产生的羟基自由基浓度；（2）保护细胞膜、线粒体和内质网等重要细胞器的膜结构完整性；（3）抗炎、抗凋亡；（4）改善脑水肿
钙离子通道阻滞剂	尼莫地平、利多氟嗪	目前缺少存在脑保护作用的足够证据
兴奋性氨基酸受体拮抗剂	地佐环平、氯胺酮、苯妥英、拉莫三嗪	暂无足够证据支持或反对使用兴奋性氨基酸受体拮抗剂
皮质醇	糖皮质激素	暂无足够证据支持或反对使用皮质醇改善生存或神经功能预后
辅酶Q10	辅酶Q10	目前缺少存在脑保护作用的足够证据

脑保护药物类型	常见药物	作用
丁苯酞	丁苯酞	（1）提高线粒体ATP酶及复合酶Ⅳ活性，保护线粒体膜结构和功能的完整，改善能量代谢；（2）提高脑细胞ATP水平和利用率，减轻脑损伤；（3）改善缺血区微循环，促进脑血流量恢复；（4）抗自由基作用，促进脑缺血患者神经功能的恢复；（5）抗炎、抗凋亡作用；（6）改善神经系统预后
自由基清除剂	依达拉奉	（1）抑制黄嘌呤氧化酶和次黄嘌呤氧化酶的活性，刺激前列环素的生成，减少白三烯的产生，降低脑缺血后产生的羟基自由基浓度；（2）保护细胞膜、线粒体和内质网等重要细胞器的膜结构完整性；（3）抗炎、抗凋亡；（4）改善脑水肿
钙离子通道阻滞剂	尼莫地平、利多氟嗪	目前缺少存在脑保护作用的足够证据
兴奋性氨基酸受体拮抗剂	地佐环平、氯胺酮、苯妥英、拉莫三嗪	暂无足够证据支持或反对使用兴奋性氨基酸受体拮抗剂
皮质醇	糖皮质激素	暂无足够证据支持或反对使用皮质醇改善生存或神经功能预后
辅酶Q10	辅酶Q10	目前缺少存在脑保护作用的足够证据

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