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心脏骤停后的神经认知功能评估。

Assessment of neurocognitive function after cardiac arrest.

机构信息

Department of Clinical Sciences Lund, Neurology, Lund, Skane University Hospital, Lund University, Lund, Sweden.

出版信息

Curr Opin Crit Care. 2019 Jun;25(3):234-239. doi: 10.1097/MCC.0000000000000607.

Abstract

PURPOSE OF REVIEW

Impaired neurocognitive function is common in cardiac arrest survivors and the use of specific neurocognitive assessments are recommended in both clinical trials and daily practice. This review examines the most recent evidence to guide in the selection of neurocognitive outcome assessment tools after cardiac arrest.

RECENT FINDINGS

Neurocognitive impairment after cardiac arrest was recently reported as one of the major predictors for societal participation, highlighting the need for neurocognitive assessments. A subjective report is a simple method to screen for cognitive problems, but divergent findings were reported when comparing with objective measures. A standardized observer report may be useful for cognitive screening postcardiac arrest. The Montreal Cognitive Assessment (MoCA) was recommended for cognitive screening after cardiac arrest. Detailed neurocognitive assessments were reported as valuable for in-depth evaluation of patients in interventional studies. The best time-point for neurocognitive assessments remains unknown. Recent findings report that most neurocognitive recovery is seen within the first months after cardiac arrest, with some improvement also noted between 3 and 12 months postcardiac arrest.

SUMMARY

Neurocognitive assessments after cardiac arrest are important and the approach should differ depending on the clinical situation. Large, prospective, well designed studies, to guide the selection of neurocognitive assessments after cardiac arrest, are urgently needed.

摘要

目的综述

心跳骤停幸存者常存在神经认知功能障碍,临床试验和日常实践中均推荐使用特定的神经认知评估。本综述旨在探讨最新证据,以指导心跳骤停后神经认知结局评估工具的选择。

最近的发现

心跳骤停后神经认知障碍最近被报道为社会参与的主要预测因素之一,这突出了神经认知评估的必要性。主观报告是筛查认知问题的一种简单方法,但与客观测量相比,报告结果存在差异。标准化观察者报告可能有助于心跳骤停后的认知筛查。蒙特利尔认知评估(MoCA)被推荐用于心跳骤停后的认知筛查。详细的神经认知评估被报道对于介入性研究中患者的深入评估具有重要价值。神经认知评估的最佳时间点仍不清楚。最近的研究结果表明,大多数神经认知恢复发生在心跳骤停后的最初几个月内,在心跳骤停后 3 至 12 个月间也有一定程度的改善。

总结

心跳骤停后进行神经认知评估非常重要,评估方法应根据临床情况而有所不同。目前迫切需要开展大型、前瞻性、精心设计的研究,以指导心跳骤停后神经认知评估的选择。

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