Tepecik Training and Research Hospital, Department of Anesthesiology and Reanimation İzmir, Turkey.
Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Turkey.
Am J Emerg Med. 2018 Dec;36(12):2236-2241. doi: 10.1016/j.ajem.2018.04.016. Epub 2018 Apr 9.
The aim of our study is to research the role and efficacy of cerebral oximetry in predicting neurologic prognosis when applied during TTM to patients experiencing coma after CA.
This study was performed on surviving adult comatose patients after CA treated with TTM. The average scores of rSO was measured at 6h intervals for the first 2days and once a day for the following 3days with a NIRS device during TTM. The CPC scale was used to define the neurologic outcomes of patients. We compared the correlations of rSO values between good (CPC 1-2) and poor (CPC 3-5) neurologic outcomes in CA patients.
There was no statistically significant difference identified between the prognosis groups in terms of rSO, CPR durations, hemoglobin values and admission body temperature (p>0.05). When the variation in rSO values over time is investigated, though there was no significant difference between the good and poor prognosis groups, it appeared to fall in the first 6h in both prognosis groups. The median NT-proBNP and lactate values were observed to be higher in the poor prognosis group.
There is no significant correlation between rSO values and neurologic outcomes. Multimodal monitoring methods may be useful and further studies with a larger patient population are necessary in this area.
本研究旨在探讨经颅多普勒超声(TTM)中脑氧饱和度(rSO)在预测 CA 后昏迷患者神经预后中的作用和疗效。
本研究纳入接受 TTM 治疗的 CA 后存活的成年昏迷患者。在 TTM 过程中,使用近红外光谱仪(NIRS)设备在第 1 天和第 2 天每 6 小时测量一次 rSO 的平均评分,在随后的 3 天每天测量一次。采用 CPC 量表定义患者的神经结局。我们比较了 CA 患者 rSO 值与良好(CPC 1-2)和不良(CPC 3-5)神经结局之间的相关性。
rSO、CPR 持续时间、血红蛋白值和入院体温在预后组之间无统计学差异(p>0.05)。当研究 rSO 值随时间的变化时,尽管在良好和不良预后组之间没有显著差异,但在两组中 rSO 值似乎在最初的 6 小时内下降。不良预后组的中位 NT-proBNP 和乳酸值较高。
rSO 值与神经预后之间无显著相关性。多模态监测方法可能有用,在这一领域需要进一步研究更大的患者人群。