Zeng Hui, Asakawa Tetsuya
Department of Health Services Section, National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, Guangdong, China.
Institute of Neurology, National Clinical Research Center for Infectious Diseases, Shenzhen Third People's Hospital, Shenzhen, Guangdong, China.
Intractable Rare Dis Res. 2024 Nov 30;13(4):199-202. doi: 10.5582/irdr.2024.01060.
Hypoxic-ischemic encephalopathy (HIE), caused by cardiac arrest (CA) is a refractory condition in clinical settings. The clinician and family members have to make a hard decision: continue expensive life-sustaining therapy or withdraw the expensive intervention. The core problem lies in "whether this patient can still be awakened and achieve neurological recovery". This study briefly summarizes the use of mainstream neuro-prognosticative tools thus far with the latest available evidence. To gain a better understanding of the pathophysiological state of patients with HIE, comprehensive use of these tools and repeated assessments are recommended. The final decision should be made cautiously and comprehensively in light of the patient's medical history, pathophysiological state, results of neuro-prognosticative evaluations, and the clinician's clinical experience . Novel computerized technologies such as artificial intelligence, big data, and machine learning should be used to develop neuro-prognosticative tools for refractory CA-induced HIE.
心脏骤停(CA)所致的缺氧缺血性脑病(HIE)在临床环境中是一种难治性病症。临床医生和家属必须做出艰难的决定:继续进行昂贵的维持生命治疗还是停止这种昂贵的干预措施。核心问题在于“该患者是否仍能苏醒并实现神经功能恢复”。本研究简要总结了目前主流神经预后评估工具的使用情况及最新可得证据。为了更好地了解HIE患者的病理生理状态,建议综合使用这些工具并进行反复评估。应根据患者的病史、病理生理状态、神经预后评估结果以及临床医生的临床经验,谨慎且全面地做出最终决定。应利用人工智能、大数据和机器学习等新型计算机技术来开发针对难治性CA所致HIE的神经预后评估工具。