nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2024-13-1-79-87nmp-1794Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSДистанционное ишемическое посткондиционирование при черепно-мозговой травме: обзор экспериментальных и клинических исследованийRemote Ischemic Postconditioning in Case of Traumatic Brain Injury: a Review of Experimental and Clinical Studieshttps://orcid.org/0000-0001-5613-3863ЩербакН. С.ShcherbakN. S.

Щербак Наталия Сергеевна - доктор биологических наук, старший научный сотрудник лаборатории неотложной кардиологии научно-исследовательского института сердечно-сосудистых заболеваний, старший научный сотрудник лаборатории биофизики кровообращения Института биомедицины ФГБОУ ВО ПСПбГМУ им. акад. И. П. Павлова МЗ РФ.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6/8

Natalia S. Shcherbak - Doctor of Biological Sciences, Senior Researcher of the Laboratory of Emergency Cardiology, Research Institute of Cardiovascular Diseases; Senior Researcher of the Laboratory of Circulatory Biophysics, Institute of Biomedicine of the I.P. Pavlov First Saint Petersburg SMU.

6–8, L’va Tolstogo Str., Saint Petersburg 197022

shcherbakns@yandex.ruhttps://orcid.org/0000-0002-0340-4110ВознюкИ. А.VoznyukI. A.

Вознюк Игорь Алексеевич - доктор медицинских наук, профессор, профессор кафедры неврологии, заместитель главного врача по неврологии ФГБОУ ВО ПСПбГМУ им. акад. И.П. Павлова МЗ РФ.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6/8

Igor A. Voznyuk - Doctor of Medical Sciences, Professor, Department of Neurology; Deputy Chief Physician for Neurology.

6–8, L’va Tolstogo Str., Saint Petersburg 197022

voznjouk@yandex.ruФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет имени академика И.П. Павлова» МЗ РФРоссияI.P. Pavlov First Saint Petersburg State Medical UniversityRussian Federation2024150420241317987Copyright © Щербак Н.С., Вознюк И.А., 20242024Щербак Н.С., Вознюк И.А.Shcherbak N.S., Voznyuk I.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/1794

Актуальность Черепно-мозговая травма (ЧМТ) остается одной из ведущих причин заболеваемости и смертности населения во всем мире. Несмотря на достижения в лечении, основанные на понимании механизмов повреждения головного мозга после ЧМТ, существует очевидная потребность в новых терапевтических стратегиях. В качестве нефармакологической методики для уменьшения вторичного повреждения головного мозга и улучшения клинических исходов у пациентов с ЧМТ может рассматриваться дистанционное ишемическое посткондиционирование (ДИПостК).

Цель исследования Повышение информированности врачей скорой помощи, нейрохирургов, неврологов, нейрофизиологов о возможном использовании концепции ДИПостК у пациентов с ЧМТ.

Материал и методы Для достижения поставленной цели были проанализированы Результаты клинических и экспериментальных исследований применения ДИПостК после ЧМТ. Поиск литературы проводили в электронных поисковых системах PubMed (https://pubmed.ncbi.nlm.nih.gov), eLibrary (https:// elibrary.ru) по ключевым словам: «черепно-мозговая травма», «дистанционное ишемическое кондиционирование». Систематический поиск и отбор публикаций был выполнен в январе–феврале 2023 года. Результаты обзора включали пациентов с установленным диагнозом «черепно-мозговая травма» с последующим применением ДИПостК и животных с экспериментальным моделированием ЧМТ различными способами с последующим ДИПостК.

Заключение Совокупность данных позволяет предположить, что применение концепции дистанционного ишемического посткондиционирования в качестве неинвазивной протективной методики при оказании неотложной помощи у пациентов с черепно-мозговой травмой может способствовать ограничению вторичного повреждения головного мозга. Однако лежащие в основе нейропротективные процессы довольно сложны и нуждаются в дальнейшем изучении. Установление взаимосвязи гуморальных, нейрогенных и воспалительных реакций в ответ на применение дистанционного ишемического посткондиционирования при черепно-мозговой травме будет способствовать пониманию механизмов формирующейся нейропротекции, поможет облегчить течение заболевания и улучшить клинический исход.

Relevance Traumatic brain injury (TBI) remains one of the leading causes of morbidity and mortality worldwide. Despite advances in treatment based on understanding of the mechanisms of brain injury after TBI, there is a clear need for new therapeutic strategies. Remote ischemic postconditioning (RIPostC) can be considered as a non-pharmacological technique to reduce secondary brain damage and improve clinical outcomes in patients with TBI.

Aim of study Raising awareness of emergency physicians, neurosurgeons, neurologists, neurophysiologists about the possible use of the concept of RIPostC in patients with TBI.

Material and methods To achieve this goal, the Results of clinical and experimental studies of the use of RIPostC after TBI were analyzed. Literature search was carried out in electronic search systems PubMed (https://pubmed.ncbi.nlm.nih.gov), eLibrary (https://elibrary.ru) using the keywords: “traumatic brain injury”, “remote ischemic conditioning”. A systematic search and selection of publications was performed in January–February 2023. The results of the review included patients with an established diagnosis of traumatic brain injury, followed by the use of RIPostC and animals with experimental modeling of TBI in various ways, followed by RIPostC.

Conclusion The totality of data suggests that the use of the concept of RIPostC as a non-invasive protective technique in the provision of emergency care for patients with TBI may contribute to limiting secondary brain damage. However, the underlying neuroprotective processes are quite complex and need further study. Establishing the relationship of humoral, neurogenic and inflammatory reactions in response to the use of RIPostC in TBI will contribute to understanding the mechanisms of emerging neuroprotection, help ease the course of the disease and improve the clinical outcome.

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The authors declare that there are no conflicts of interest present.