March 21 2017
We would like to inform you that the 21st IRCMS Seminar was held as below.
Date: March 16, 2017 (Thu)
Time: 16:00 - 17:00
Venue: 2F Seminar Room, Yamasaki Memorial Hall
Mr. Dmitriy Viderman, M.D.
Anesthesiologist and Critical Care Physician
Nazarbayev University School of Medicine, Kazakhstan
National Research Neurosurgery Center, Kazakhstan
"Potential Benefits of Hemofiltration in Acute Ischemic Stroke Management"
Stroke is a major healthcare issue globally leading to high morbidity and mortality. It is the world leading cause of disability. The prognosis for acutely ill patients with ischemic stroke admitted to the ICU is currently very poor. Of those who survive ICU admission, the majority have a poor quality of life. Theoretically, stroke has three main pathophysiological mechanisms of neurotoxicity: glutamate-induced neurotoxicity (Stage one); free radicals induced neurotoxicity (stage 2); neuroinflammation (stage 3).
Hypothetically and practically, hemofiltration can affect all three stages, reducing the level of intracerebral glutamate, free-radicals, preventing and reducing neuroinflammation by clearing proinflammatory and inflammatory substances. Hemofiltration might be safe and efficacious modality of acute ischemic stroke treatment. It can positively affect the following pathophysiological mechanisms: 1) Reduce glutamate levels in blood plasma and cerebrospinal fluid; 2) Lower glutamate levels can be associated with a smaller evolution infarct volume. We also hypothesize that hemofiltration can reduce the concentration of free radicals and mitigate the free radical-induced neurotoxicity and reduce the concentration of pro-inflammatory and inflammatory factors and mitigate the neuroinflammation. Further studies are needed to assess the efficacy of hemofiltration in acute ischemic stroke treatment.