Research advances in pharmacotherapy for brain injury after cardiopulmonary resuscitation
10.3969/j.issn.1008-9691.2025.04.021
- VernacularTitle:心肺复苏后脑损伤的药物治疗研究进展
- Author:
Xiaozhan YANG
1
;
Yifan HUANG
;
Sisen ZHANG
Author Information
1. 河南中医药大学第五临床医学院,河南 郑州 450002
- Publication Type:Journal Article
- Keywords:
Cardiac arrest;
Cardiopulmonary resuscitation;
Cerebral ischemia reperfusion injury;
Neuroprotection;
Pharmacological therapy;
Traditional Chinese medicine
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2025;32(4):499-503
- CountryChina
- Language:Chinese
-
Abstract:
Cardiac arrest is characterized by the sudden cessation of cardiac activity,accompanied by the abrupt loss of respiration and consciousness,leading to ischemia-hypoxia in vital organs and subsequently resulting in irreversible damage.Even among patients who achieve return of spontaneous circulation(ROSC),only approximately 1%attain favorable neurological functional outcomes.The primary driver of this poor prognosis is cerebral ischemia reperfusion injury(CIRI)following cardiopulmonary resuscitation(CPR).Pharmacological intervention has become a key strategy to improve neurological recovery in these patients.Currently,a wide range of agents targeting CIRI are diverse,with diverse mechanisms of action.Commonly used clinical drugs and their mechanisms include:①Anti-inflammatory agents:Minocycline mitigates inflammation by modulating microglial polarization,while aspirin improves cerebral microcirculation via anti-platelet aggregation;②Antioxidative stress agents:Mitoquinone mesylate(MitoQ)selectively targets,mitochondria to scavenge reactive oxygen species(ROS),while Edaravone dexborneol rapidly inhibits oxidative damage through broad-spectrum free radical scavenging;③Mitochondrial dysfunction-targeted agents:Methylene blue restores energy metabolism by stabilizing mitochondrial membrane potential and inhibiting mitochondrial permeability transition pore(MPTP)opening;④Multi-targeted traditional Chinese medicine(TCM)therapy:Angong Niuhuang Wan and Danshen Chuanxiongqin alleviate brain injury by inhibiting inflammasomes,suppressing astrocyte activation,and modulating relevant signaling pathways,demonstrating the synergistic advantage of a"multi-component-multi-target"mechanism.This review systematically summarizes the mechanisms of action and research progress of these agents,aiming to provide a theoretical basis for clinical drug selection in post-CA management.
