Lasting s-ketamine block of spreading depolarizations in subarachnoid hemorrhage: a retrospective cohort study
Abstract
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.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Dec 01, 2019
- Source ID
- 10.1186/s13054-019-2711-3
Entities
People
- Adrian Hernández Aguilera
- Andreas W. Unterberg
- Arturo Olivares-rivera
- Coline L. Lemale
- Edgar Santos
- Jed A Hartings
- Jens Peter Dreier
- Johannes Woitzik
- Kevin Kunzmann
- Lorenz Uhlmann
- Mildred Gutierrez Herrera
- Modar Kentar
- Oliver W. Sakowitz
- Renán Sánchez-porras
- Roland Zerelles
- Sebastian Major
- Vasilis Kola
Organizations
- German Research Foundation
- United States Army