在儿科住院心脏骤停后获得神经成像的实践模式
Matthew P Kirschen1, Natalie L Ullman2, Ron W Reeder3
1Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA USA; Division of Neurology, Department of Pediatrics, The Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA USA.
Resuscitation
|January 23, 2025
概括
在住院心脏骤停 (IHCA) 后的神经影像根据患者和停止因素而有所不同. 超声波,CT和MRI的使用取决于特定的临床指标和现场实践,影响心脏骤停后的诊断选择.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 关键护理医学 关键护理医学
背景情况:
- 住院心脏骤停 (IHCA) 的幸存者通常需要神经成像来评估神经结果.
- 了解影响神经成像方式选择的因素对于逮捕后护理优化至关重要.
研究的目的:
- 为了确定与IHCA后获得神经成像相关的患者和心脏骤停因素.
- 确定与幸存者使用的特定神经成像模式 (超声波,CT,MRI) 相关的因素.
主要方法:
- 在ICU-RESUS试验中招募的1000名IHCA幸存者的回顾性队列研究.
- 分析神经成像频率和时间 (超声波,CT,MRI) 在逮捕后7天内.
- 多变量模型用于识别与神经成像采集和模式选择相关的因素.
主要成果:
- 44%的IHCA幸存者接受了神经成像:超声波 (31%),CT (18%),MRI (6%).
- 与任何神经成像相关的因素包括心脏骤停在CICU,更长的CPR,ECMO,有针对性的温度管理和EEG监测.
- 选择方法各不相同:对先天性心脏病进行超声波检查,对较年长的婴儿进行CT检查/预先停止残疾检查,对呼吸系统问题/特定疾病类别进行MRI检查.
结论:
- 在IHCA之后的神经成像实践不一致.
- 患者的特征,心脏骤停细节和机构因素显著影响执行神经成像和选择模式的决定.
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