Journal of neurosurgical anesthesiology
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J Neurosurg Anesthesiol · Jul 2013
The effects of peritoneal dialysis on blood glutamate levels: implementation for neuroprotection.
Previous study has demonstrated the efficacy of hemodialysis in reducing blood glutamate levels. The purpose of the present study is to investigate whether peritoneal dialysis (PD) may be effective in lowering blood glutamate levels, which may serve as a potential tool for improving neurological function after brain injury. ⋯ We demonstrated that PD is an effective modality in reducing blood glutamate concentrations. This method may be potentially utilized for the treatment of acute and chronic brain disorders that are accompanied by elevated glutamate in the brain's extracellular fluid. Considering the rapid saturation of the PD solution with glutamate, we recommend frequent dwelling of the PD solution in order to maintain low concentrations of blood glutamate.
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J Neurosurg Anesthesiol · Jul 2013
Hypocapnia in aneurysmal subarachnoid hemorrhage: incidence and association with poor clinical outcomes.
The impact of hypocapnia on outcome in aneurysmal subarachnoid hemorrhage (SAH) is unclear, although hypocapnia is associated with poor outcome in other brain injuries. We sought to determine the incidence and impact of hypocapnia in mechanically ventilated patients with aneurysmal SAH. ⋯ Hypocapnia is common in ventilated patients with aneurysmal SAH, and a significant proportion of this developed spontaneously despite minimal ventilator support. The duration of hypocapnia is independently associated with poor functional outcomes and symptomatic vasospasm. Further study is warranted to confirm a causal link between hypocapnia and poor outcomes, and to confirm whether tight control of PaCO2 might improve outcomes in aneurysmal SAH.
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J Neurosurg Anesthesiol · Jul 2013
Propofol promotes proliferation of cultured adult rat hippocampal neural stem cells.
The effect of propofol on proliferation of adult neural stem cells (ANSCs) is unclear. We investigated the effect of propofol on cultured rat ANSCs and the underlying molecular mechanisms, especially the role of activated cAMP response element binding protein (CREB). ⋯ Propofol acts partly through a Ca-mediated pathway to enhance CREB phosphorylation. We believe this mechanism promotes the in vitro proliferation of ANSCs.