Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector15310.17816/psaic153ReviewsОбзорыUnknownMechanisms of therapeutic hypothermia effect on brain damage in hypoxia and ischemiaМеханизмы воздействия индуцированной гипотермии на патофизиологические каскады церебрального повреждения и репарации при гипоксии и ишемииPopugaevK. A.ПопугаевK. A.
Russian Federation
Stan.Popugaev@yahoo.comHutorenkoA. A.ХуторенкоA. A.
Russian Federation
Stan.Popugaev@yahoo.comN.N. Burdenko Neurosurgical Research InstituteФГБНУ «НИИ Нейрохирургии имени акад. Н.Н. Бурденко»Lomonosov Moscow State UniversityМГУ имени М.В. Ломоносова, факультет биоинженерии и биоинформатики1003201591515901022017Copyright ©; 2015, Popugaev K.A., Hutorenko A.A.Copyright ©; 2015, Popugaev K.A., Hutorenko A.A.2015Popugaev K.A., Hutorenko A.A.Popugaev K.A., Hutorenko A.A.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/153

Ischemia and hypoxia are major factors of brain damage. Cerebral injury takes time to develop, with acute, subacute, and chronic phases specified. Reparative processes run simultaneously with damage cascades. Every phase of cerebral injury is characterized with specific pathophysiological cascades. Induced hypothermia has been implemented in neurocritical care for several decades, and its efficacy has been proved in patients after cardiac arrest and in newborns with perinatal hypoxic-ischemic encephalopathy. However, in other neurocritical care settings the efficacy of has not been demonstrated yet. On the other hand, the results of experimental studies and discovered mechanisms of hypothermia effects on pathophysiological cascades of cerebral injury and repair give hope for the hypothermia to become a valuable option for the neurocritical care. In the presented review hypothermia effects on numerous pathophysiological cascades of cerebral injury due to hypoxia and ischemia are described.

Ишемия и гипоксия, являясь наиболее важными факторами церебрального повреждения, запускают многочисленные патофизиологические каскады, опосредующие непосредственное повреждение клеток мозга. Церебральное повреждение происходит не одномоментно, а разворачивается в течение определенного времени, поэтому выделяют острый, подострый и хронический периоды церебральной катастрофы. Параллельно с повреждающими механизмами развиваются репаративные процессы, и для каждого периода характерны свои патофизиологические каскады. Индуцированная гипотермия как метод интенсивной терапии в практике нейрореанимации существует уже не одно десятилетие. За это время индуцированная гипотермия доказала свою эффективность и нейропротективный потенциал у пациентов, переживших остановку сердца и у новорожденных с ишемически-гипоксическим перинатальным повреждением мозга. Однако в других группах нейрореанимационных пациентов эффективность гипотермии до сих пор не доказана. Вместе с этим результаты лабораторных исследований и выявленные механизмы воздействия гипотермии на каскады клеточного повреждения и репарации позволяют возлагать на гипотермию большие надежды. В представленном обзоре описаны многочисленные механизмы воздействия гипотермии на патофизиологические каскады при церебральном повреждении.

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