Berek K, Jeschow M, Aichner F
Department of Neurology and Rehabilitation, Osterr. Landeskrankenhaus Hochzirl, Austria.
Eur Neurol. 1997;37(3):135-45. doi: 10.1159/000117426.
Early determination of outcome after out-of-hospital cardiopulmonary resuscitation is a common problem with great ethical, economic, social and legal consequences. Although there has been a fulminant development of emergency medicine during the last three decades, severe cerebral damage sometimes cannot be avoided. For neurological outcome prediction after cardiac arrest clinical neurological signs, electrophysiological examinations, neuroimaging tests, and laboratory parameters in serum and cerebrospinal fluid are used today, nevertheless, there still remains a considerable degree of uncertainty. However, although prognostic criteria which enable the clinician to stop treatment cannot be given at the present time, useful applications of early prognostication after cardiac arrest range from counseling of families, triage decisions, and do-not-resuscitate decisions to future clinical investigations of brain resuscitative measures.
院外心肺复苏后早期判定预后是一个常见问题,会产生重大的伦理、经济、社会和法律后果。尽管在过去三十年急诊医学有了迅猛发展,但有时仍无法避免严重的脑损伤。目前,心脏骤停后用于预测神经学预后的方法包括临床神经体征、电生理检查、神经影像学检查以及血清和脑脊液中的实验室参数,然而,仍存在相当程度的不确定性。不过,尽管目前尚无法给出能让临床医生停止治疗的预后标准,但心脏骤停后早期预后评估的有用应用范围广泛,从对家属的咨询、分诊决策、不进行心肺复苏决策到未来脑复苏措施的临床研究。