在后毒性状态后,良好的结果的电图和临床决定因素是
Marjolein M Admiraal1,2, Sofia Backman1,2, Martin Annborn3,4
1Department of Clinical Sciences, Clinical Neurophysiology, Lund University, Sweden.
Neurology
|February 11, 2025
概括
后毒性电图状态 (PSE) 可以与良好的结果相兼容,当它有晚期发作并且没有不良预后指标时. 良好的PSE概况显著增加了心脏骤停后良好的长期康复的可能性.
科学领域:
- 神经学 神经学
- 关键护理医学 关键护理医学
- 神经生理学 神经生理学
背景情况:
- 后毒性电图状态 (PSE) 发生在昏迷患者中高达三分之一的心脏骤停 (CA) 后患者中,与高死亡率相关.
- 幸存者有时表现出PSE晚期发病 (>24小时) 来自连续的背景模式,缺乏确定的不良结果指标.
研究的目的:
- 确定与所有PSE患者相比,具有有利PSE概况的患者长期良好结果的概率增加.
- 评估心脏骤停幸存者的特定PSE呈现的预后意义.
主要方法:
- 对TTM2试验 (NCT02908308) 的前性观察性副研究,涉及昏迷状态的CA患者,并进行持续的EEG (cEEG) 监测.
- 用于PSE分类的标准化EEG术语,对临床数据视而不见.
- 4日多模式预后;良好的结果定义为6个月后修改的兰金度表0-3,随着24个月的随访.
主要成果:
- 52/191 (27%) 患者在CA.后42小时的中位数发展出PSE.
- 在20名患者 (38%) 中确定了有利的PSE概况,其中60%的患者存活到6个月,40%的患者获得了良好的结果 (概率增加了2.7倍).
- 所有没有有利概况的患者都表现不佳;所有表现良好的幸存者在7天内服从命令,并在24个月后表现出良好的功能表现.
结论:
- 如果发病时间较晚,从连续的背景,并且没有确定的不良预后指标,PSE与良好的结果相容.
- 三分之一的PSE患者具有良好的形象,超过三分之一的人取得了良好的结果和提高了意识水平.
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