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院外心脏骤停持续较长时间后的显著恢复:缺氧缺血性脑病(HIE)与后部可逆性脑病综合征(PRES)——病例报告

Remarkable recovery following prolonged out-of-hospital cardiac arrest: hypoxic-ischemic encephalopathy (HIE) versus posterior reversible encephalopathy syndrome (PRES)-a case report.

作者信息

Singer Nashat, Abdelbagi Muzan, Alzuabi Abeer, Elsayed Muaz Abdellatif Mohammed

机构信息

Department of Critical Care, Al-Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates.

Department of Anesthesia, Al-Qassimi Hospital, Emirates Health Services, Sharjah, United Arab Emirates.

出版信息

AME Case Rep. 2024 Aug 5;8:89. doi: 10.21037/acr-23-218. eCollection 2024.

DOI:10.21037/acr-23-218
PMID:39380876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11459391/
Abstract

BACKGROUND

Cardiac arrest is the most dramatic event that compromises the cerebral blood flow with fatal outcomes. Factors like the presence of bystander cardiopulmonary resuscitation, initial rhythm, and arrest time significantly influence outcomes. However, despite these known factors, there are still aspects of cardiac arrest-related neurological complications that remain less understood. As evidenced by limited case reports, the association between posterior reversible encephalopathy syndrome (PRES) and cardiac arrest is not widely known.

CASE DESCRIPTION

We present a case study of out-of-hospital cardiac arrest (OHCA) involving a patient with multiple comorbidities and factors that could complicate her neurological outcome. Despite experiencing a delayed recovery following the cardiac arrest event and an initial insult to the brain, the patient exhibited remarkable neurological recovery. There has been a complex individualized targeted management that contributed to the favorable outcome.

CONCLUSIONS

This case study provides valuable insights into the complexities of managing OHCA patients, the factors influencing recovery, and the importance of a multidisciplinary team for early diagnosis and treatment of conditions like PRES to prevent permanent neurological damage. Further research into this area is necessary to better understand the mechanisms and implications of such associations for improving patient care and outcomes following cardiac arrest.

摘要

背景

心脏骤停是最严重的事件,会损害脑血流并导致致命后果。旁观者心肺复苏术的实施情况、初始心律和骤停时间等因素会显著影响预后。然而,尽管存在这些已知因素,但心脏骤停相关神经并发症的某些方面仍未得到充分理解。有限的病例报告表明,后部可逆性脑病综合征(PRES)与心脏骤停之间的关联并不广为人知。

病例描述

我们呈现了一例院外心脏骤停(OHCA)的病例研究,患者存在多种合并症及可能使其神经预后复杂化的因素。尽管心脏骤停事件后恢复延迟且脑部最初受到损伤,但患者仍表现出显著的神经功能恢复。复杂的个体化靶向治疗促成了良好的预后。

结论

本病例研究为管理OHCA患者的复杂性、影响恢复的因素以及多学科团队对早期诊断和治疗PRES等病症以预防永久性神经损伤的重要性提供了宝贵见解。有必要对该领域进行进一步研究,以更好地理解此类关联的机制及其对改善心脏骤停后患者护理和预后的意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/baf5f09daf23/acr-08-23-218-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/f3f52d631b80/acr-08-23-218-f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/17df38893e37/acr-08-23-218-f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/baf5f09daf23/acr-08-23-218-f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/f3f52d631b80/acr-08-23-218-f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/92d5a7377697/acr-08-23-218-f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/a59d1c4ae4c9/acr-08-23-218-f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e1/11459391/17d6b1080438/acr-08-23-218-f4.jpg
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本文引用的文献

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