Evaluation of coma patients after cardiopulmonary resuscitation  

作　　者：SU Ying-ying YANG Qing-lin PANG Ying LV Xiang-ping 

机构地区：[1]Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China

出　　处：《Chinese Medical Journal》2005年第21期1808-1811,共4页中华医学杂志（英文版）

基　　金：This work was supported by a grant from the Beijing MunicipalScience &Technology Commission (No.953304003)

摘　　要：Background Coma after cardiopulmonary resuscitation （CPR） is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR . Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score （GCS） , brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography （EEG）, brainstem auditory evoked potential （BAEP）, short latency somatosensory evoked potential （SLSEP）, and transcranial Doppler （TCD） .Results Twenty-four of 35 patients（68.57% ）were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient. Twenty-four patients died within 1 month and 11 of them （ 45. 83% ） were determined as brain death. Glasgow outcome score （GOS） was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as grade Ⅰ in 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients. Two patients（ 18.18% ）regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively. Conclusion objectively Combined or continuous evaluation of clinical examinations and laboratory tests can accurately determine brain function after CPR.Background Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR .Methods From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS),brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG),brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD) .Results Twenty-four of 35 patients(68.57%)were in deep coma. The GCS was 3 except for 2 patients;EEG was evaluated not less than grade Ⅳ except for 4 patients, BAEP was evaluated as grade Ⅲ except for 3 patients, and SLSEP was evaluated as grade Ⅲ except for 1 patient.Twenty-four patients died within 1 month and 11 of them(45.83%)were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade Ⅰ. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeⅠin 5 patients, BAEP and SLSEP were evaluated as grade Ⅰ in 3 patients, and GOS was all evaluated as grade Ⅱ among the 11 patients.Two patients(18.18%)regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade Ⅳ and Ⅲ, respectively.Conclusion Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.

关 键 词：cardiopulmonary resuscitation coma brain death electroencephalography evoked potentials ultrasonography DOPPLER TRANSCRANIAL 

分 类 号：R741.041[医药卫生—神经病学与精神病学] R654.1[医药卫生—临床医学]