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结果。对于超过 50 万遭受苦难的美国人 每年都会发生心脏骤停的情况，目前的治疗方法不足，结果也很糟糕。其中还有更多 超过 100,000 名患者恢复了脉搏，严重的全球性脑损伤很常见，并且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。 我的提案涉及两个重要的、可能可预防的逮捕后死亡和残疾原因 脑损伤。第一个问题是持续组织缺氧造成的继发性脑损伤 复苏后几天内灌注不足。不准确的神经学检查结果会进一步恶化 预测，这会因患者过早退出护理而直接增加死亡率 否则可能会有良好的恢复。定量脑电图（qEEG）是一种工具 测量脑电活动的各个组成部分或整体特征，并可能有助于克服 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是否 qEEG可以无创地检测脑组织缺氧和低灌注。我们已经使用侵入式监测 测量脑氧和灌注，提供前所未有的同时测试机会 根据公认的临床参考标准获得 qEEG。二次 qEEG 标记的鉴定 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 签名预测后续的能力 神经功能恶化和死亡，并测试其作为多步预后算法要素之一的价值。 目前，准确的预测在逮捕后几天才是最佳的。这对家庭、资源来说都是负担 强化治疗，通常会导致患者过早停止维持生命的治疗 如果他们有更多的时间康复的话，他们已经觉醒并能够独立生活。 该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的负担。的 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 并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.