Konsep GHOST- CAP untuk Proteksi Otak Perioperatif pada Cedera Otak Traumatik

Abstract

Brain damage is an injury that causes damage or worsening of brain cells caused by various conditions such as head trauma, inadequate oxygen supply, infection or intracranial hemorrhage. Brain protection is a preemptive measure of therapeutic interventions to improve neurological outcomes in patients at risk of cerebral ischemic, while brain resuscitation refers to therapeutic interventions that begin after the occurrence of ischemic. The target is ischemic therapy and reducing neuronal injury. Perioperative brain damage is one of the most serious adverse complications of surgery and anesthesia, resulting in new postoperative neurological deficits. The concept of GHOST-CAP, an acronym for Glycemia, Hemoglobin, Oxygen, Sodium, Temperature, Comfort, Arterial Pressure and PaCO2, can be used in the postoperative period. G: The target level of glucose is between 80 and 180 mg/dL. H: hemoglobin threshold is 7-9 g/dL. O: oxygen, target SpO2 between 94 and 97%. S: Sodium concentration affects brain volume, sodium levels up to 155 mEq/L are tolerable. T: temperatures regulated to optimize cellular function, but core temperatures > 38.0°C should be avoided. C: patient comfort, including pain control, agitation, anxiety, and chills. A: Arterial blood pressure is the main determinant of cerebral blood flow (CBF), maintaining an mean arterial pressure (MAP) of 80 mmHg and cerebral perfusion pressure (CPP) of 60 mmHg. P: Acute changes in PaCO2 cause CBF changes, PaCO2 not to be less than 35 mmHg. This paper examines the GHOST-CAP concept for perioperative brain protection, whether adequate or should be supplemented