皮质体感官唤起的潜在幅度和心脏骤停后的临床结果:一个回顾性多中心研究
Noelle Aalberts1, Erik Westhall2, Birger Johnsen3
1Department of Neurology, AG Emergency and Critical Care Neurology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Journal of neurology
|August 28, 2023
概括
双边缺席的皮质体感官唤起潜力 (SSEP) 和低于0.5μV的振幅强烈预测了心脏骤停幸存者的不良结果. 一个标准化的SSEP评估途径确保可靠的预后.
科学领域:
- 神经科学是一个神经科学.
- 关键护理医学 关键护理医学
- 神经学 神经学
背景情况:
- 昏迷性心脏骤停 (CA) 患者的结果通常是由双边缺席的皮质体感官唤起潜能 (SSEP) 预测的.
- 皮层SSEP振幅提供了潜在的预后延伸,但门和协议指标需要澄清.
研究的目的:
- 确定皮质SSEP振幅值,用于预测昏迷的CA患者的结果.
- 评估标准化皮质SSEP评价的相互记录和相互评价协议.
主要方法:
- 一项回顾性多中心队列研究分析了昏迷的CA患者皮质SSEP振幅.
- 使用标准化评估途径,重复SSEP和由四名评级人员进行独立评估.
- 大脑性能类别 (CPC) 在出院时的得分定义为良好的 (CPC 1-3) 与差的 (CPC 4-5) 结果.
主要成果:
- 在706名患者中,39.2%的结果是好的,60.8%的结果是不好的.
- 在99.2%的病例中,双边缺席的皮质SSEP预测了糟糕的结果.
- 皮层SSEP振幅低于0.5μV与糟糕的结果有关,而更高的振幅表明没有严重的脑损伤. 评价者之间的一致性很好 (弗莱斯的卡帕=0.88).
结论:
- 皮层SSEP振幅低于0.5μV和双边缺席的SSEP是昏迷的CA患者不良结果的高度特异性预测因素.
- 标准化的评估途径确保SSEP预测的高可靠性和一致性.
- 在双边缺席皮质SSEP的患者中,恢复意识是罕见的,高SSEP振幅可能表明大脑功能得到保护.
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