Arterial blood pressure after human cardiac arrest and neurological recovery
Arterial blood pressure after human cardiac arrest and neurological recovery
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DOI：
10.1161/01.str.27.1.59
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发表时间：
1996-01-01
期刊：
影响因子：
8.3
通讯作者：
Laggner, AN
中科院分区：
文献类型：
--
作者：
Mullner, M;Sterz, F;Laggner, AN
背景和目的在动物心脏骤停研究中，通过在自主循环恢复后早期诱导动脉高血压可以改善结果。方法对136例心脏性猝死患者进行回顾性分析，将自主循环恢复后5 min内平均动脉压（MABP）≥ 100 mm Hg的患者分为两组：1组为自主循环恢复后5 min内平均动脉压（MABP）≥ 100 mm Hg的患者;第2组，MABP ≤ 100 mm Hg，此后每隔5 min测定一次MABP，直至自主循环恢复后2 h。比较各组的年龄、性别、住院/出院、有无目击者、首次心电图心律、从心脏骤停到开始生命支持和恢复自主循环的时间、肾上腺素累积给药剂量，结果1组（n=54）神经功能恢复良好者占63%，2组（n=82）神经功能恢复良好者占55%。χ（2）=0.57，P=NS）。两组的基线值相当，但第1组从生命支持开始至自主循环恢复的时间间隔较短。在我们用斯皮尔曼偏等级相关（r（s））控制了这种差异后，在前5分钟内测量的MABP与结果之间没有关联（r（s）=-.023; P=NS）。良好的神经功能恢复与自主循环恢复后2小时内测量的MABP独立且直接相关（r（s）=.26; P
Background and Purpose In animal cardiac arrest studies, outcome has been improved by inducing arterial hypertension early after return of spontaneous circulation. The aim of our study was to evaluate whether arterial blood pressure within the first minutes and hours after return of spontaneous circulation influences neurological recovery in human cardiac arrest survivors.Methods Of 136 retrospectively evaluated patients after sudden cardiac death, two groups were defined: group 1, mean arterial blood pressure (MABP) within 5 minutes after return of spontaneous circulation above 100 mm Hg; group 2, MABP of 100 mm Hg or less. Thereafter MABP was measured every 5 minutes until 2 hours after return of spontaneous circulation. The groups were compared in regard to age, sex, in/out of hospital, witnessed/not witnessed, first electrocardiographic rhythm, time from cardiac arrest to beginning of life support and to return of spontaneous circulation, cumulative epinephrine dose administered, and best neurological outcome within 6 months.Results In group 1 (n=54) good neurological recovery was observed in 63% and in group 2 (n=82) in 55% (chi(2)=0.57, P=NS). Both groups exhibited comparable baseline values except that time intervals from beginning of life support to return of spontaneous circulation were shorter in group 1. After we controlled for this difference with Spearman's partial rank correlation (r(s)), there was no association between MABP measured within the first 5 minutes and outcome (r(s)=-.023; P=NS). Good neurological recovery was independently and directly related to MABP measured during 2 hours after return of spontaneous circulation (r(s)=.26; P