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新发性耐火状态的长期结果:一项回顾性研究

Federica Stretti¹, Stefan Yu Bögli², Francesca Casagrande¹

¹Institute of Intensive Care Medicine, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.

Critical care (London, England)

|March 13, 2024

概括

新发性耐火状态 (NORSE) 患者可以在长时间的重症监护室停留后恢复. 早期的生命终结决定可能是过早的,因为生存者的功能结果随着时间的推移而得到改善.

科学领域:

神经临界护理是指神经临界护理.
神经学神经学
密集护理医学是密集护理的医学.

背景情况:

新发 refractory status epilepticus (NORSE) 是一种严重的神经疾病,其原因尚不清楚.
患者经常经历长时间的重症监护室 (ICU) 停留,导致对治疗无用的看法.
即使在严重的NORSE病例中,也可能恢复.

研究的目的:

调查NORSE患者的重症监护室 (ICU) 治疗方法.
在NORSE案例中分析短期和长期结果.
检查在NORSE管理中的道德决策,包括生命终端 (EOL) 选择.

主要方法:

对25名进入神经关键病房的NORSE患者进行了回顾性研究.
数据收集包括人口统计,临床信息,疗法和结果.
用描述性统计数据来分析数据.

主要成果:

大多数NORSE患者都是女性,以前健康,相对年轻.
超耐火性SE存在于96%的病例中,68%的病例仍然是密码性.
住院死亡率为36%,长期随访时死亡率为56%,89%的住院死亡是由于暂停/取消治疗造成的.
随着时间的推移,医院幸存者 (mRS 4至2) 的功能结果显著改善.

结论:

尽管复杂的ICU课程,NORSE幸存者的长期结果可能是有利的.
临床医生必须谨慎做出终身决策,以避免自我实现的预言.
在最初不耐药的NORSE病例中,建议继续治疗.

关键词:

生命的终结生命的终结修改的排名尺度修改的排名尺度新发病的耐火性状态性结果结果的结果.状态性病的状态

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