Fugate Jennifer E
Department of Neurology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
Neurol Clin. 2017 Nov;35(4):601-611. doi: 10.1016/j.ncl.2017.06.001.
Improvements in cardiopulmonary resuscitation and intensive care medicine have led to declining mortality rates for patients with out-of-hospital cardiac arrest, but overall it is still a minority that achieves good outcomes. Estimating neurologic prognosis for patients that remain comatose after resuscitation remains a challenge and the need for accurate and early prognostic predictors is crucial. A thoughtful approach is required and should take into account information acquired from multiple tests in association with neurologic examination. No decision should be made based on a single predictor. In addition to clinical examination, somatosensory evoked potentials, electroencephalogram, serum biomarkers, and neuroimaging provide complimentary information to inform prognosis.
心肺复苏和重症监护医学的进步已使院外心脏骤停患者的死亡率有所下降，但总体而言，仍只有少数患者能获得良好预后。对复苏后仍昏迷的患者进行神经学预后评估仍然是一项挑战，准确且早期的预后预测指标至关重要。需要采取周全的方法，应考虑从多项检查以及神经学检查中获取的信息。不应仅基于单一预测指标做出决策。除临床检查外，体感诱发电位、脑电图、血清生物标志物和神经影像学可为判断预后提供补充信息。
