心停止後の神経保護戦略に関する系統的レビュー:基礎から臨床へ(第II部:包括的保護)
Neurocognitive impairment is a major source of morbidity among cardiac arrest survivors. This systematic review examined neuroprotective strategies targeting multiple stages of the neuropathological cascade following global cerebral ischemia. Pharmaceutical candidates reviewed included adenosine, brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), glycine-proline-glutamate, granulocyte colony-stimulating factor (G-CSF), and estrogen; preclinical data for these agents were suggestive but inconclusive. Among medical gases evaluated in experimental models—hydrogen sulfide, hyperbaric oxygen, and molecular hydrogen—hyperbaric oxygen and molecular hydrogen demonstrated encouraging outcomes. The authors conclude that multi-target neuroprotective approaches hold promise for improving neurological recovery and survival, though clinical translation requires additional investigation.
Molecular hydrogen and hyperbaric oxygen are proposed to confer neuroprotection by modulating multiple steps within the neuropathological cascade triggered by global cerebral ischemia following cardiac arrest, though precise mechanistic details remain under investigation.
The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).
See also:
https://h2-papers.org/en/papers/25671079