Reappearance of Motor-Evoked Potentials During the Rewarming Phase After Deep Hypothermic Circulatory Arrest
Reappearance of Motor-Evoked Potentials During the Rewarming Phase After Deep Hypothermic Circulatory Arrest
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DOI：
10.1053/j.jvca.2017.05.046
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发表时间：
2018-04-01
影响因子：
2.8
通讯作者：
Ohnishi, Yoshihiko
中科院分区：
文献类型：
--
作者：
Kanemaru, Eiki;Yoshitani, Kenji;Ohnishi, Yoshihiko
目的：虽然运动诱发电位（MEP）在深低温停循环（DHCA）中消失，但MEP已用于确认DHCA后运动功能是否完好。了解MEP再现的时间、体温和MEP振幅对DHCA后脊髓缺血的检测至关重要。然而，关于这些参数的数据很少。作者调查了DHCA后MEP复发的特征。设计：回顾性观察性研究。设置：单一国家中心。参与者：2013年1月至2015年12月期间接受DHCA降主动脉置换术和胸腹主动脉置换术的61例患者。干预：无。测量和主要结果：作者提取了以下数据：下肢停循环结束后MEP再现的时间、MEP恢复时的膀胱温度（BT）和鼻咽温度（NPT）以及MEP再现时MEP相对于对照值的振幅%。MEP重现的中位时间约为70分钟。MEP再现时的BT范围为34.3 ℃至34.6 ℃，NPT范围为36.2 ℃至36.4 ℃。在MEP再现时，在超过50%的患者中观察到%振幅小于对照值的50%。MEP恢复时间与复温时间（p < 0.01）和BT（p = 0.03）呈显著正相关。当腿部的欧洲议会议员恢复时，BT大约是34摄氏度。复温时间和BT对MEP恢复时间有显著影响。(C)2017爱思唯尔公司All rights reserved.
Objective: Although motor-evoked potentials (MEPs) disappear in deep hypothermic circulatory arrest (DHCA), MEPs have been used to confirm whether motor function is intact after DHCA. It is crucial to know the timing, body temperature, and MEP amplitude at MEP reappearance to detect spinal cord ischemia after DHCA. However, data on these parameters are sparse. The authors investigated the characteristics of MEPs at reappearance after DHCA.Design: A retrospective observational study.Setting: Single national center.Participants: Sixty-one patients who underwent descending aortic replacement and thoracoabdominal aortic replacement with DHCA between January 2013 and December 2015.Interventions: None.Measurements and Main Results: The authors extracted the following data: time to MEP reappearance after the end of lower extremity circulatory arrest, bladder temperature (BT) and nasopharyngeal temperature (NPT) when MEPs recovered, and %amplitude of MEPs relative to control values at MEP reappearance. The median time to MEP reappearance was approximately 70 minutes. BT at MEP reappearance ranged from 34.3 degrees C to 34.6 degrees C and NPT ranged from 36.2 degrees C to 36.4 degrees C. At MEP reappearance, %amplitude less than 50% of the control value was observed in more than 50% of patients. Time to MEP reappearance had a significant positive association with rewarming time (p < 0.01) and BT (p = 0.03).Conclusions: There was a wide variation in MEP amplitude at reappearance during the rewarming phase. BT was approximately 34 degrees C when MEPs in the leg recovered. The time to MEP reappearance is influenced significantly by rewarming time and BT. (C) 2017 Elsevier Inc. All rights reserved.