Neuropsychiatric Protection In Critically Ill Patients

Abstract

Cellular and vascular biological responses to deprivation of energy supply to the brain make the need to strategies of brain protection a matter of interest aiming to increase tolerance of tissue to ischaemia resulting in improved outcome (Morales et al.,2007). Brain ischemia may be global or focal, as well as complete or incomplete. Complete global ischemia occurs with cardiac arrest; incomplete global ischemia occurs with hypotension or shock. Focal ischemia involves the occlusion of a single vessel and is thus incomplete (Drummond&Patel,2000). For providing cerebral protection we deal with multiple physiological methods suchas, temperature, blood pressure, serum glucose level, arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2)(Liu et al.,2012). As regard to temperature effect, it was felt that hypothermic protection was based on a significant decrease in cerebral metabolism. However, it has subsequently been shown that profound hypothermia is not required to protect the brain(Liu et al.,2012). Dealing with blood pressure , it is said that maintenance of normal or slightly increased blood pressure is indicated to increase collateral perfusion to the area of brain transiently robbed of its blood supply (Schwarz et al.,2002).