Effect of different mild therapeutic hypothermia judged by bispectral index in patients with cardiopulmonary resuscitation
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摘要: 目的:评估脑电双频指数(BIS)对心肺复苏术后患者接受不同亚低温治疗策略的疗效。方法:选择2014-04—2016-12期间ICU心肺复苏术后患者80例,分为常温组,短时程亚低温治疗组和长时程亚低温治疗组。常温组给予常规治疗,亚低温治疗组在此基础上给予患者亚低温治疗。短时程亚低温治疗组给予患者持续亚低温治疗24 h,而长时程亚低温治疗组给予患者持续亚低温治疗7 d。记录各组患者1~10 d的APACHEⅡ评分、GCS评分以及BIS值。比较每组患者第1、3、5、7、10天的APACHEⅡ评分、GCS评分、BIS值以及患者28 d的生存率和6个月的CPC评分。结果:3组患者第1、3天的APACHEⅡ评分、GCS评分以及BIS值评分比较均差异无统计学意义(P>0.05),3组患者第5、7、10天APACHEⅡ评分、GCS评分以及BIS值比较均差异有统计学意义(P<0.05)。患者28 d生存率和6个月的CPC评分3组之间比较均差异有统计学意义(P<0.05)。结论:BIS值可以评估心肺复苏术后患者不同亚低温治疗的疗效,亚低温治疗对心肺复苏术后患者28 d生存率和6个月的神经功能恢复有明显改善作用,且长时程亚低温治疗较短时程亚低温治疗,具有更好的提高患者生存率以及改善患者神经功能预后的作用。
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关键词:
- 脑电双频指数 /
- 心肺复苏术后 /
- 亚低温治疗 /
- Glascow昏迷评分
Abstract: Objective:To study the application effect of 2 different mild hypothermia therapy judged by the Bispectral Index(BIS) in patients with cardiopulmonary resuscitation. Method:A total of 80 adult patients with cardiopulmonary resuscitation were selected in the intensive care unit of our hospital from April 2014 to December 2016, and they were divided into the control group,the short-time mild hypothermia group and the long-time mild hypothermia group according to therapeutic methods. Patients of control group received conventional treatment, while patients of mild hypothermia group received mild hypothermia therapy based on conventional treatment. The sub-hypothermia duration was 24 h in the short-time mild hypothermia group, while the sub-hypothermia duration was 7 d in the long-time mild hypothermia group. For all patients, the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ) score and Glascow Coma Scale score(GCS) and BIS were measured and recorded from the first day to the tenth day. The APACHE Ⅱ score,GCS and BIS scores on the 1 st, 3 rd, 5 th, 7 th and 10 th, as well as the 28 d survival rate and the 6-month cerebral performance category(CPC) scores were compared for each group. Result:The APACHEⅡ score, GCS and BIS of the three groups had no significant difference on the 1 st and 3 rd days(P>0.05). But the APACHEⅡ score, GCS and BIS were significantly different among the three groups on the 5 th, 7 th and 10 th day(P<0.05). There were significant differences in the 28-day survival rate and the 6-month CPC score for each group(P<0.05).Conclusion:The BIS value can evaluate the effect of different mild hypothermia therapy in patients after cardiopulmonary resuscitation. The mild hypothermia therapy had significant improved the 28-day survival rate and the neurological function recovery for the patients after cardiopulmonary resuscitation. Meanwhile, the long-time mild hypothermia therapy is more effective than short-time mild hypothermia therapy in improving the survival rate and neurological prognosis of patients. -
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[1] Peberdy MA,Callaway CW,Neumar RW,et al.Part 9:post cardiac arrest care:2010 American heart Association Guidelines for Cardiopul-monary Resuscitation and Emergency Cardiovascular Care[J].Circulation,2010,122:S768-S786.
[2] Nielsen N,Wetterslev J,Cronberg T,et al.Targeted temperature management at 33℃ versus 36℃ after cardiac arrest[J].N Engl J Med,2013,369:2197-2206.
[3] Bhanji F,Donohue AJ,Wolff MS,et al.Part14:Education:2015 American Heart Associtation Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care[J].Circulation,2015,132:561-573.
[4] Moritz H,Christoph T,Fritz S,et al.Relationship between time to target temperature and outcome in patients treated with therapeutic hypothermia after cardiac arrest[J].Crit Care,2011,15 (2):101-112.
[5] Kirkegaard H,Pedersen AR,Pettilä V,et al.A statistical analysis protocol for the time-differentiated target temperature management after out-of-hospital cardiac arrest(TTH48) clinical trial[J].Scand J Trauma Resusc Emerg Med,2016,24(2):138-145.
[6] Anders MG,Bent RRN,Peter JO,et al.Effect of prolonged targeted temperature management on left ventricular myocardial function after out-of-hospital cardiac arrest-A randomised,controlled trial[J].Resuscitation,2017,115:23-31
[7] Eveson L,Vizcaychipi M,Patil S,et al.Role of bispectral index monitoring and burst suppression in prognostication following out-of-hospital cardiac arrest:a systematic review protocol[J].Syst Rev,2017,6(1):191-196.
[8] 裴学勇,马耀,任节.脑电双频指数、乳酸对心肺复苏术后患者预后的评估价值[J].中国急救复苏与灾难医学杂志,2018,13(9):841-843.
[9] 杜兰芳,李昭屏,马青变.亚低温对于心搏骤停患者复苏后心脏功能的影响[J].临床急诊杂志,2019,20(1):33-35.
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