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急性缺血性卒中再灌注治疗的时间决策

Time-Based Decision Making for Reperfusion in Acute Ischemic Stroke.

作者信息

Grøan Mathias, Ospel Johanna, Ajmi Soffien, Sandset Else Charlotte, Kurz Martin W, Skjelland Mona, Advani Rajiv

机构信息

Faculty of Medicine, University of Oslo, Oslo, Norway.

Department of Radiology, Basel University Hospital, Basel, Switzerland.

出版信息

Front Neurol. 2021 Nov 1;12:728012. doi: 10.3389/fneur.2021.728012. eCollection 2021.

Abstract

Decision making in the extended time windows for acute ischemic stroke can be a complex and time-consuming process. The process of making the clinical decision to treat has been compounded by the availability of different imaging modalities. In the setting of acute ischemic stroke, time is of the essence and chances of a good outcome diminish by each passing minute. Navigating the plethora of advanced imaging modalities means that treatment in some cases can be inefficaciously delayed. Time delays and individually based non-programmed decision making can prove challenging for clinicians. Visual aids can assist such decision making aimed at simplifying the use of advanced imaging. Flow charts are one such visual tool that can expedite treatment in this setting. A systematic review of existing literature around imaging modalities based on site of occlusion and time from onset can be used to aid decision making; a more program-based thought process. The use of an acute reperfusion flow chart helping navigate the myriad of imaging modalities can aid the effective treatment of patients.

摘要

在急性缺血性卒中的延长时间窗内进行决策可能是一个复杂且耗时的过程。不同成像方式的出现使做出治疗的临床决策过程变得更加复杂。在急性缺血性卒中的情况下,时间至关重要,每过一分钟,良好预后的机会就会减少。在众多先进成像方式中做出选择意味着在某些情况下治疗可能会被无效延迟。时间延迟和基于个体的非程序化决策对临床医生来说可能具有挑战性。视觉辅助工具可以帮助进行此类决策,旨在简化先进成像的使用。流程图就是这样一种视觉工具,可以在这种情况下加快治疗速度。基于闭塞部位和发病时间对现有关于成像方式的文献进行系统综述,可用于辅助决策;这是一种更基于程序的思维过程。使用急性再灌注流程图来帮助在众多成像方式中做出选择,可以有助于对患者进行有效治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1792/8591257/dbd4a77a845b/fneur-12-728012-g0001.jpg

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