von Edgar Santos ; Arturo Olivares-Rivera ; Sebastian Major ; Renán Sánchez-Porras ; Lorenz Uhlmann ; Kevin Kunzmann ; Roland Zerelles ; Modar Kentar ; Vasilis Kola ; Adrian Hernandez Aguilera ; Mildred A. Gutierrez-Herrera ; Coline L. Lemale ; Johannes Woitzik ; Jed A. Hartings ; Oliver Sakowitz ; Andreas Unterberg ; Jens P. Dreier
Spreading depolarizations (SD) are characterized by breakdown of transmembrane ion gradients and excitotoxicity. Experimentally, N-methyl-d-aspartate receptor (NMDAR) antagonists block a majority of SDs. In many hospitals, the NMDAR antagonist s-ketamine and the GABAA agonist midazolam represent the current second-line combination treatment to sedate patients with devastating cerebral injuries. A pressing clinical question is whether this option should become first-line in sedation-requiring individuals in whom SDs are detected, yet the s-ketamine dose necessary to adequately inhibit SDs is unknown. Moreover, use-dependent tolerance could be a problem for SD inhibition in the clinic.
Critical care London : BioMed Central, 1997 23(2019), Artikel-ID 427, Seite 1-14 Online-Ressource