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择期电复律心房颤动后脑局部血氧饱和度增加是短暂的,对神经心理学功能无有益影响:电复律期间的脑血氧饱和度。

Increase in regional cerebral saturation after elective electrical cardioversion of atrial fibrillation is only transient and without beneficial effects on neuropsychological functioning: cerebral saturation during electrical cardioversion.

机构信息

Department of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium.

Department of Anaesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Ziekenhuis Oost-Limburg, Genk, Belgium.

出版信息

J Clin Monit Comput. 2021 Feb;35(1):165-173. doi: 10.1007/s10877-020-00458-2. Epub 2020 Jan 8.

Abstract

We aimed to confirm the positive association between a successful electrical cardioversion (ECV) and increase in SctO and investigated whether this increase is persisting or not. Secondary, the influence of a successful ECV on the neuropsychological function and the association with SctO was assessed as well. SctO was measured continuously during elective ECV using near-infrared spectroscopy. Measurements started before induction of sedation and ended 15 min after awakening. A second measurement took place 4 to 6 weeks after ECV. To assess neuropsychological functioning, patients performed standardized neuropsychological tests before ECV and at follow-up and were compared to healthy volunteers as control group. SctO was measured in 60 patients during elective ECV. ECV was successful in 50 AF patients, while in ten patients sinus rhythm was not obtained. SctO increased immediately after successful ECV in 50 patients (1% (- 5 to 4); p = 0.031), but not after unsuccessful ECV in 10 patients (- 1% (- 5;3); p = 0.481). This SctO change was positively correlated with the instant change in blood pressure (R = 0.391; p = 0.004). At follow-up, SctO values were no longer increased. Nevertheless, successful ECV improved the patient's quality of life but did not influence neuropsychological functioning at follow-up. A transient, instant SctO increase was observed after successful ECV. This temporary increase in SctO did not influence the neuropsychological functioning of the patients. Though, the quality of life of patients with a successful ECV improved.

摘要

我们旨在确认电复律(ECV)成功与 SctO 增加之间的正相关关系,并研究这种增加是否持续存在。其次,评估 ECV 成功对神经心理学功能的影响及其与 SctO 的关联。使用近红外光谱法在选择性 ECV 期间连续测量 SctO。测量在诱导镇静之前开始,并在苏醒后 15 分钟结束。第二次测量在 ECV 后 4 至 6 周进行。为了评估神经心理学功能,患者在 ECV 之前和随访时进行了标准化的神经心理学测试,并与健康志愿者作为对照组进行比较。在 60 名接受选择性 ECV 的患者中测量了 SctO。在 50 例 AF 患者中 ECV 成功,而在 10 例患者中未获得窦性节律。在 50 例成功 ECV 的患者中,SctO 在 ECV 后立即增加(1%(-5 至 4);p=0.031),而在 10 例不成功 ECV 的患者中则没有增加(-1%(-5;3);p=0.481)。这种 SctO 变化与血压的即时变化呈正相关(R=0.391;p=0.004)。在随访时,SctO 值不再增加。尽管如此,ECV 成功改善了患者的生活质量,但在随访时对神经心理学功能没有影响。在成功的 ECV 后观察到短暂的瞬间 SctO 增加。这种 SctO 的暂时增加不会影响患者的神经心理学功能。尽管如此,ECV 成功的患者生活质量有所改善。

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