Quantitative electroencephalography after cardiac arrest

标题：心脏骤停后的定量脑电图 摘要 脑损伤是危重疾病最可怕的后果。对于50多万遭受苦难的美国人来说 每年心脏骤停，目前的治疗方法不足，结果糟糕透顶。在更多中 超过10万名恢复脉搏的患者，严重的全球脑损伤是常见的，也是两者的主要驱动因素 发病率和死亡率。这是一个重大的公共卫生问题。 我的建议涉及逮捕后死亡和残疾的两个重要的、可能可以预防的原因 脑部受伤。第一个问题是持续的组织缺氧和继发性脑损伤 复苏后几天的低灌注率。不准确的神经系统会使结果进一步恶化。 预测，这直接增加了患者过早退出护理的死亡率 否则可能会有良好的复苏。定量脑电(QEEG)是一种 测量脑电活动的个别成分或整体特征，可能有助于克服 这两个问题。在我们的第一个目标中，我们将使用创新的统计方法来确定 定量脑电可以无创地检测脑组织缺氧和低灌注量。我们已经在使用侵入性监控 测量大脑的氧气和灌注量，提供了一个前所未有的同时测试的机会 对照公认的临床参考标准获得QEEG。继发性脑脊髓炎的定量脑电标志物鉴定 脑损伤将允许基于个性化需求和实时的早期和非侵入性患者护理 对治疗的反应。在第二个目标中，我们将定义qEEG信号预测后续事件的能力 神经恶化和死亡，并测试其作为多步预测算法的一个要素的价值。 目前，准确的预测只有在被捕后几天才是最佳的。这对家庭、资源来说是负担 强度大，通常会导致患者过早停止生命维持治疗 如果给他们更多的时间来恢复，他们已经觉醒并能够独立生活。 这个职业发展奖将直接有助于我的长期研究目标，即开发、测试和 实施创新的治疗策略，减轻危重病人可预防的脑损伤负担。这个 该奖项将为我提供实现这些目标所需的跨学科指导经验和培训 成为一名富有成效的独立调查员。

Title: Quantitative electroencephalography after cardiac arrest Abstract Brain injury is the most dreaded result of critical illness. For more than half a million Americans who suffer sudden cardiac arrest each year, current therapies are inadequate and outcomes are abysmal. Among more than 100,000 patients who regain pulses, severe global brain injury is common and the major driver of both morbidity and mortality. This is a major public health problem. My proposal addresses two important, potentially preventable causes of death and disability due to post-arrest brain injury. The first of these problems is secondary brain injury from ongoing tissue hypoxia and hypoperfusion in the days after resuscitation. Outcomes are further worsened by inaccurate neurological prognostication, which directly increases mortality through premature withdrawal of care in patients who might otherwise have had favorable recoveries. Quantitative electroencephalography (qEEG) is a tool that measures individual components or overall characteristics of electrical brain activity, and may help overcome both of these problems. In our first aim, we will use innovative statistical methods to determine whether qEEG can noninvasively detect brain tissue hypoxia and hypoperfusion. We already use invasive monitoring to measure brain oxygen and perfusion, providing an unprecedented opportunity to test contemporaneously acquired qEEG against accepted clinical reference standards. Identification of qEEG markers of secondary brain injury would allow early and non-invasive patient care based on individualized need and real-time response to therapy. In the second aim, we will define the ability of qEEG signatures to predict subsequent neurological deterioration and death, and test its value as one element of a multistep prognostic algorithm. Currently, accurate prognostication is optimal only days after arrest. This is burdensome for families, resource intensive and often leads to premature withdrawal of life-sustaining therapy in patients who would otherwise have awakened and been able to live independently had they been given more time to recover. This career development award will directly contribute to my long-term research goals to develop, test, and implement innovative treatment strategies that reduce the burden of preventable brain injury in the critically ill. The award will provide me with the cross-disciplinary mentored experience and training necessary to achieve these goals and become a productive independent investigator.