Cerebral Protection

For brain metabolism, energy is derived from circulatory provision of oxygen and glucose. Surgery, anaesthesia, peri-operative stresses or other etiological factors can lead to decrease in oxygen supply leading to ischemia, with consequent interruption of metabolic process. This Ischemia stimulates active responses in the brain, which may persist long after substrate delivery has been restored. These responses include apoptosis and inflammation, inhibition of protein synthesis, sustained oxidative stress, and neurogenesis. All these factors culminate to ischemic brain damage, which may result in sub-clinical neurocognitive deficit to catastrophic neurological morbidity or death.