Cerebral therapy
Cerebral care in the context of resuscitation involves:
- reverse initial ischaemia by treating arrest and maintaining output
- failure of reperfusion and treatable causes:
- vasospasm: calcium antagonists, avoid calcium
- oedema: avoid hypercarbia, avoid sodium bicarbonate, perhaps hyperventilate
- microthrombi or sludging
Cerebral therapeutic measures include
- rapid return of spontaneous circulation
- ventilate to hypocarbia: 4 kPa
- barbiturate therapy: may act by slowing metabolism
- hypothermia
- steroids
- free radical scavenger - the lazaroids
- intracerebral pressure monitor
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