Neurological aspects of reanimatology.
The science of resuscitation and correspondingly the more effective methods of death management have come up to the place of a century-old, as a rule, empirical struggle for the life of a dying human being. Mechanisms of dying and resuscitation have become the objects of comprehensive scientific research. Studies of the mechanisms of genesis of hypoxia and posthypoxic pathology of the brain have allowed us to reveal the whole complex of postischaemical factors participating in the development of post-resuscitation encephalopathies, among which the leading ones are the changes in the energy formation processes, disorders in protein and phospholipid metabolism, activation of proteolysis enzymes and changes in the state of membrane systems of neurons. Central nervous system damage is caused not only by direct influence of hypoxia in the brain, but also by a number of extracerebral factors, among which endogenous intoxication plays an important role. Restoration of cardiac activity and respiration, stabilization of metabolism help revive the brain and reverse damage caused by dying. But it is not sufficient. Neurologic therapy aimed at the restoration of brain functions is absolutely indispensable. It must be started from the moment of the patient's admission to an intensive care unit and be constantly recurred on the patient's discharge from hospital (rehabilitation therapy). Many processes occurring in the terminal period differ from those taking place in a living or even sick organism. And very often they look like processes contradicting general life conceptions. In a detailed study it becomes obvious that these contradictions are not errors in cognition or contradictions from the point of view of formal logic.(ABSTRACT TRUNCATED AT 250 WORDS)
Negovsky
V A
VA
Institute of General Reanimatology AMSci USSR Moscow.
D002545:Brain Ischemia / Q000534:rehabilitation; D006801:Humans; D012151:Resuscitation