Ducharme-Crevier Laurence, Press Craig A, Kurz Jonathan E, Mills Michele G, Goldstein Joshua L, Wainwright Mark S
1Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL. 2Department of Pediatrics, Division of Neurology, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.
Pediatr Crit Care Med. 2017 May;18(5):452-460. doi: 10.1097/PCC.0000000000001137.
The role of sleep architecture as a biomarker for prognostication after resuscitation from cardiac arrest in children hospitalized in an ICU remains poorly defined. We sought to investigate the association between features of normal sleep architecture in children after cardiac arrest and a favorable neurologic outcome at 6 months.
Retrospective review of medical records and continuous electroencephalography monitoring.
Cardiac and PICU of a tertiary children's hospital.
All patients from 6 months to 18 years old resuscitated from cardiac arrest who underwent continuous electroencephalography monitoring in the first 24 hours after in- or out-of-hospital cardiac arrest from January 2010 to June 2015.
None.
Thirty-four patients underwent continuous electroencephalography monitoring after cardiac arrest. The median age was 6.1 years (interquartile range, 1.5-12.5 yr), 20 patients were male (59%). Most cases (n = 23, 68%) suffered from in-hospital cardiac arrest. Electroencephalography monitoring was initiated a median of 9.3 hours (5.8-14.9 hr) after return of spontaneous circulation, for a median duration of 14.3 hours (6.0-16.0 hr) within the first 24-hour period after the cardiac arrest. Five patients had normal spindles, five had abnormal spindles, and 24 patients did not have any sleep architecture. The presence of spindles was associated with a favorable neurologic outcome at 6-month postcardiac arrest (p = 0.001).
Continuous electroencephalography monitoring can be used in children to assess spindles in the ICU. The presence of spindles on continuous electroencephalography monitoring in the first 24 hours after resuscitation from cardiac arrest is associated with a favorable neurologic outcome. Assessment of sleep architecture on continuous electroencephalography after cardiac arrest could improve outcome prediction.
在入住重症监护病房（ICU）的儿童中，睡眠结构作为心脏骤停复苏后预后生物标志物的作用仍未明确界定。我们试图研究心脏骤停后儿童正常睡眠结构特征与6个月时良好神经功能转归之间的关联。
对病历和持续脑电图监测进行回顾性分析。
一家三级儿童医院的心脏科和儿科重症监护病房。
2010年1月至2015年6月期间，所有6个月至18岁因心脏骤停复苏且在院内心脏骤停或院外心脏骤停后24小时内接受持续脑电图监测的患者。
无。
34例患者在心脏骤停后接受了持续脑电图监测。中位年龄为6.1岁（四分位间距为1.5 - 12.5岁），20例为男性（59%）。大多数病例（n = 23，68%）为院内心脏骤停。自主循环恢复后，脑电图监测的中位启动时间为9.3小时（5.8 - 14.9小时）；在心脏骤停后的首个24小时内，监测的中位持续时间为14.3小时（6.0 - 16.0小时）。5例患者纺锤波正常，5例纺锤波异常，24例患者无任何睡眠结构。纺锤波的出现与心脏骤停后6个月时良好的神经功能转归相关（p = 0.001）。
持续脑电图监测可用于儿童ICU中评估纺锤波。心脏骤停复苏后24小时内持续脑电图监测出现纺锤波与良好的神经功能转归相关。心脏骤停后通过持续脑电图评估睡眠结构可改善预后预测。
