Neurological prognostication after cardiac arrest and targeted temperature management 33 °C versus 36 °C: Results from a randomised controlled clinical trial
Neurological prognostication after cardiac arrest and targeted temperature management 33 °C versus 36 °C: Results from a randomised controlled clinical trial
复制标题
DOI：
10.1016/j.resuscitation.2015.04.013
复制
发表时间：
2015-08-01
期刊：
影响因子：
6.5
通讯作者：
Cronberg, Tobias
中科院分区：
文献类型：
--
作者：
Dragancea, Irina;Horn, Janneke;Cronberg, Tobias
背景：自从引入诱导低温以来，院外心脏骤停后一些神经学预测方法的可靠性一直受到质疑。本研究的目的是确定复苏后不同的治疗温度是否影响昏迷患者临床神经学表现和体感诱发电位 (SSEP) 的预后准确性。方法：我们使用院外心脏骤停试验后目标温度管理的前瞻性数据计算了格拉斯哥昏迷量表运动评分 (GCS M)、瞳孔和角膜反射以及 SSEP 的敏感性和假阳性率，以预测不良的神经学结果。将 939 名昏迷幸存者随机分配到 33 摄氏度或 36 摄氏度进行治疗。不良结果定义为六个月时出现严重残疾、植物人状态或死亡（大脑功能类别量表 3-5）。结果：对 313 名患者 (33%) 进行了预后评估； 33℃组有168个，36℃组有145个。地面站中号
Background: The reliability of some methods of neurological prognostication after out-of-hospital cardiac arrest has been questioned since the introduction of induced hypothermia. The aim of this study was to determine whether different treatment temperatures after resuscitation affected the prognostic accuracy of clinical neurological findings and somatosensory evoked potentials (SSEP) in comatose patients.Methods: We calculated sensitivity and false positive rate for Glasgow Coma Scale motor score (GCS M), pupillary and corneal reflexes and SSEP to predict poor neurological outcome using prospective data from the Target Temperature Management after Out-of-Hospital Cardiac Arrest Trial which randomised 939 comatose survivors to treatment at either 33 degrees C or 36 degrees C. Poor outcome was defined as severe disability, vegetative state or death (Cerebral Performance Category scale 3-5) at six months.Results: 313 patients (33%) were prognostically assessed; 168 in the 33 degrees C, and 145 in the 36 degrees C group. A GCS M