Stanziano Mario, Foglia Carolina, Soddu Andrea, Gargano Francesca, Papa Michele
Department of Public, Clinical, and Preventative Medicine, Second University of Naples, Italy.
Funct Neurol. 2011 Jan-Mar;26(1):45-50.
Prognostic determination of patients in coma after resuscitation from cardiac arrest is a common and difficult requirement with significant ethical, social and legal implications. We set out to seek markers that can be used for the early detection of patients with a poor prognosis, so as to reduce uncertainty over treatment and non-treatment decisions, and to improve relationships with families. We reviewed the medical literature from 1991 to 2010, using key words such as post-anoxic coma, post-anoxic vegetative state, vegetative state prognosis, recovery after cardiac arrest. Neurological examination, electrophysiology, imaging, and biochemical markers are all useful tools for estimating patients' chances of recovery from cardiac arrest. It seems unlikely that any single test will prove to have 100% predictive value for outcome; but the combination of various prognostic markers, as shown in some articles, could increase the reliability of outcome prediction. However, further research is needed.
对心脏骤停复苏后昏迷患者的预后判定是一项常见且困难的任务，具有重大的伦理、社会和法律意义。我们着手寻找可用于早期检测预后不良患者的标志物，以减少治疗和不治疗决策的不确定性，并改善与家属的关系。我们回顾了1991年至2010年的医学文献，使用了诸如缺氧后昏迷、缺氧后植物状态、植物状态预后、心脏骤停后恢复等关键词。神经学检查、电生理学、影像学和生化标志物都是评估患者心脏骤停后恢复机会的有用工具。似乎不太可能有任何单一测试对结果具有100%的预测价值；但如一些文章所示，各种预后标志物的组合可提高结果预测的可靠性。然而，仍需要进一步研究。
