The post-cardiac arrest syndrome: A case for lung–brain coupling and opportunities for neuroprotection
| Autor: | Kathleen Miller-Rhodes, Marc W. Halterman, Sara A. Knowlden, Nguyen Mai |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_treatment
030204 cardiovascular system & hematology Lung injury Targeted temperature management Return of spontaneous circulation Bioinformatics Systemic inflammation Neuroprotection Sepsis 03 medical and health sciences 0302 clinical medicine Humans Post-Cardiac Arrest Syndrome Medicine Review Articles Lung business.industry Brain medicine.disease Systemic inflammatory response syndrome Neurology Reperfusion Injury Neurology (clinical) medicine.symptom Cardiology and Cardiovascular Medicine business Reperfusion injury 030217 neurology & neurosurgery |
| Zdroj: | J Cereb Blood Flow Metab |
| ISSN: | 1559-7016 0271-678X |
| DOI: | 10.1177/0271678x19835552 |
| Popis: | Systemic inflammation and multi-organ failure represent hallmarks of the post-cardiac arrest syndrome (PCAS) and predict severe neurological injury and often fatal outcomes. Current interventions for cardiac arrest focus on the reversal of precipitating cardiac pathologies and the implementation of supportive measures with the goal of limiting damage to at-risk tissue. Despite the widespread use of targeted temperature management, there remain no proven approaches to manage reperfusion injury in the period following the return of spontaneous circulation. Recent evidence has implicated the lung as a moderator of systemic inflammation following remote somatic injury in part through effects on innate immune priming. In this review, we explore concepts related to lung-dependent innate immune priming and its potential role in PCAS. Specifically, we propose and investigate the conceptual model of lung–brain coupling drawing from the broader literature connecting tissue damage and acute lung injury with cerebral reperfusion injury. Subsequently, we consider the role that interventions designed to short-circuit lung-dependent immune priming might play in improving patient outcomes following cardiac arrest and possibly other acute neurological injuries. |
| Databáze: | OpenAIRE |
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