PATHOGENETIC MECHANISMS OF HYPOXIC-ISCHEMIC BRAIN INJURY IN CHILDREN AFTER CLINICAL DEATH
https://doi.org/10.52485/19986173_2025_4_96
Abstract
Brain death in children after clinical death is one of the most complex and urgent problems of modern pediatric intensive care. Immaturity of the nervous system, high metabolic activity, functional instability of the blood–brain barrier, and incomplete myelination determine the increased vulnerability of the child’s brain to ischemia and hypoxia. This article reviews the main pathogenetic mechanisms: primary (global ischemia, energy deficit, ion imbalance, excitotoxicity), secondary (mitochondrial dysfunction, reperfusion injury, oxidative stress, blood–brain barrier disruption, neuroinflammation), as well as different forms of cell death (apoptosis, necrosis, pathological autophagy). Particular attention is paid to the morphological consequences for the developing brain, including white matter injury, delayed myelination, and loss of neuronal networks. In children, the transition from reversible to irreversible damage occurs faster than in adults, which significantly complicates prognosis and therapeutic interventions. Current understanding of the molecular and morphological mechanisms of brain death has practical significance for improving diagnostics, prognosis, and treatment in pediatric intensive care.
About the Authors
Yu. V. Bykov
Stavropol State Medical University
Russian Federation
Russian Federation
Bykov Yu.V., Candidate of Medical Sciences, Assistant of the Department of Anesthesiology and Intensive Care with a course of additional professional education
310 Mira str., Stavropol, 355017
A. N. Obedin
Stavropol State Medical University;
Stavropol Regional Clinical Perinatal Center No. 1
Russian Federation
Russian Federation
Obedin A.N., Doctor of Medical Sciences, Head of the Department of Anesthesiology, Intensive Care with the course of additional professional education
310 Mira str., Stavropol, 355017;
355002, Stavropol, Semashko str. 3/1
O. V. Zinchenko
Stavropol State Medical University
Russian Federation
Russian Federation
Zinchenko O.V., Candidate of Medical Sciences, Associate Professor of the Department of Anesthesiology, Intensive Care with the course of additional professional education
310 Mira str., Stavropol, 355017
I. V. Yatsuk
Stavropol State Medical University;
Stavropol City Clinical Emergency Hospital
Russian Federation
Russian Federation
Yatsuk I.V., Candidate of Medical Sciences, Associate Professor of the Department of Anesthesiology, Intensive Care with the course of additional professional education
310 Mira str., Stavropol, 355017;
17 Tukhachevsky str., Stavropol, 355032
E. V. Volkov
Stavropol State Medical University;
Stavropol Regional Clinical Hospital
Russian Federation
Russian Federation
Volkov E.V., Candidate of Medical Sciences, Associate Professor of the Department of Anesthesiology, Intensive Care with the course of additional professional education
310 Mira str., Stavropol, 355017;
1 Semashko str., Stavropol, 355002
V. V. Fischer
Stavropol State Medical University;
Shpakovskaya District Hospital
Russian Federation
Russian Federation
Fischer V.V., Candidate of Medical Sciences, Associate Professor of the Department of Anesthesiology, Intensive Care with the course of additional professional education
310 Mira str., Stavropol, 355017;
1 Lenin str., Stavropol, 356240
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Review
For citations:
Bykov Yu.V., Obedin A.N., Zinchenko O.V., Yatsuk I.V., Volkov E.V., Fischer V.V. PATHOGENETIC MECHANISMS OF HYPOXIC-ISCHEMIC BRAIN INJURY IN CHILDREN AFTER CLINICAL DEATH. Transbaikalian Medical Bulletin. 2025;(4):96-111. (In Russ.) https://doi.org/10.52485/19986173_2025_4_96
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