Predictors of poor neurologic outcome after induced mild hypothermia following cardiac arrest
Predictors of poor neurologic outcome after induced mild hypothermia following cardiac arrest
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DOI：
10.1212/01.wnl.0000334205.81148.31
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发表时间：
2008-11-04
期刊：
影响因子：
9.9
通讯作者：
Young, B.
中科院分区：
文献类型：
--
作者：
Al Thenayan, E.;Savard, M.;Young, B.
背景：心脏骤停（CA）后神经功能预后不良的几个预测因子已被证明是有效的。然而，这些研究早于治疗性诱导轻度低温（TIMH）的出现，这可能会改变其有效性。本研究的目的是重新评估这些预测因素的有效性后CA患者治疗TIMH.Methods：回顾性图表审查37个连续的成年人昏迷复苏后CA和TIMH.Results治疗：没有6例患者没有瞳孔反应，6个没有角膜反射的第3天，或8个肌阵挛癫痫持续状态恢复意识。两个14例患者的运动反应不优于扩展在第3天恢复运动反应后6天逮捕（一个在5和一个在6天后复温），并恢复awareness.Conclusions：运动反应优于扩展在第3天的损失是不可靠的治疗后诱导的轻度低温昏迷心脏骤停幸存者。第3天失去瞳孔或角膜反射或出现肌阵挛癫痫持续状态的患者均未恢复意识。神经病学（R）2008;71：1535-1537
Background: Several predictors of poor neurologic outcome after cardiac arrest (CA) were proven to be valid. However, these studies preceded the advent of therapeutic induced mild hypothermia (TIMH), which may alter their validity. The objective of this study is to reassess the validity of these predictors in post-CA patients treated with TIMH.Methods: Retrospective chart review of 37 consecutive adults who were comatose after resuscitation from CA and treated with TIMH.Results: None of six patients without pupillary reactivity, six without corneal reflexes on day 3, or eight with myoclonus status epilepticus recovered awareness. Two of 14 patients with motor responses no better than extension at day 3 recovered motor responses only after 6 days post-arrest (one at 5 and one at 6 days post-rewarming) and regained awareness.Conclusions: Loss of motor responses better than extension on day 3 was not prognostically reliable after therapeutic induced mild hypothermia for comatose cardiac arrest survivors. None of the patients who lost pupillary or corneal reflexes on day 3 or developed myoclonus status epilepticus recovered awareness. Neurology (R) 2008;71:1535-1537