Department of Neurology, Division of Neurocritical Care and Emergency Neurology, Yale University School of Medicine, P.O. Box 208018, 15 York Street, LLCI Building, 10th floor, New Haven, CT, 06520, USA.
Department of Neurology, UF Health Shands Hospital, University of Florida College of Medicine, PO Box 100236, Gainesville, FL 32610, USA.
Neurol Clin. 2021 May;39(2):273-292. doi: 10.1016/j.ncl.2021.01.002. Epub 2021 Mar 31.
Cardiac arrest survivors comprise a heterogeneous population, in which the etiology of arrest, systemic and neurologic comorbidities, and sequelae of post-cardiac arrest syndrome influence the severity of secondary brain injury. The degree of secondary neurologic injury can be modifiable and is influenced by factors that alter cerebral physiology. Neuromonitoring techniques provide tools for evaluating the evolution of physiologic variables over time. This article reviews the pathophysiology of hypoxic-ischemic brain injury, provides an overview of the neuromonitoring tools available to identify risk profiles for secondary brain injury, and highlights the importance of an individualized approach to post cardiac arrest care.
心脏骤停幸存者是一个异质人群，其中，停搏的病因、全身和神经系统合并症以及心脏骤停后综合征的后遗症均会影响到继发性脑损伤的严重程度。继发性神经损伤的程度是可以改变的，并受到改变大脑生理学的因素的影响。神经监测技术为评估随时间推移的生理变量的演变提供了工具。本文回顾了缺氧缺血性脑损伤的病理生理学，概述了可用于识别继发性脑损伤风险特征的神经监测工具，并强调了对心脏骤停后护理采取个体化方法的重要性。
