心脏骤停复苏后患者体温对脑功能预后的影响 |
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引用本文: | 黄达,梁剑峰,朱曦,安友仲,李刚,李青,骆勇,王东信,李雪迎.心脏骤停复苏后患者体温对脑功能预后的影响[J].临床麻醉学杂志,2016(6):567-572. |
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作者姓名: | 黄达 梁剑峰 朱曦 安友仲 李刚 李青 骆勇 王东信 李雪迎 |
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作者单位: | 1. 100034,北京大学第一医院麻醉和重症医学科;2. 北京老年医院 ICU;3. 北京大学第三医院危重医学科;4. 北京大学人民医院重症医学科;5. 中日友好医院重症医学科;6. 北京大学临床肿瘤医院 北京肿瘤医院 北京市肿瘤防治研究所 ICU;7. 北京大学首钢医院重症医学科;8. 100034,北京大学第一医院医学统计室 |
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摘 要: | 目的探讨心脏骤停复苏后患者体温与脑功能预后的关系。方法本研究为多中心回顾性队列研究,分析1990年1月1日~2011年12月31日北京市七家三甲医院ICU收治的院内心脏骤停后自主循环恢复超过20min的患者,收集复苏治疗相关数据和其他临床资料,使用脑功能分级(CPC)评估脑功能结局,分析治疗期间体温与脑功能预后的关系。结果共纳入184例患者,其中68例(37.0%)存活至出院,36例(19.6%)出院时脑功能良好(CPC≤2)。35.5℃入ICU后第一个24h内最高体温38.4℃是脑功能预后良好的独立预测因素(OR=8.986,95%CI 1.156~69.882;P=0.036)。结论对于院内心脏骤停后恢复自主循环的患者,入ICU后24h内最高体温维持在35.6~38.3℃有利于脑功能预后。
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关 键 词: | 心脏骤停 心肺复苏 预后 亚低温 |
Effect of body temperature for favorable neurological outcome in patients of cardiac arrest |
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Abstract: | Objective To identify the association between body temperature and neurological outcome in post-arrest patients.Methods This was a multicenter,retrospective cohort study.In the period 1990-2011,a total of 184 patients resuscitated from IHCA with ROSC for more than 20 min were included.Data were collected according to Utstein style.The primary endpoint was hospital dis-charge with good neurological function (Cerebral Performance Category,CPC,1-2).Multivariate Lo-gistic regression was performed to determine the association between body temperature and neurologi-cal outcome.Results Among the 184 enrolled patients,37.0% (68/184)survived to hospital dis-charge,19.6% (36/184)survived to discharge with favorable neurological outcome(CPC,1-2).Mul-tivariate Logistic regression revealed that maximal body temperature between 35.5℃ and 38.4℃ was associated with favorable neurological outcomes (OR=8.986,95% CI 1.156-69.882;P =0.036). Conclusion For IHCA patients achieving spontaneous circulation, maximal body temperature between 35.5℃ and 38.4℃ in the initial 24 h following admission to ICU was associated with favora-ble neurological outcome. |
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Keywords: | Cardiac arrest CPR Prognosis Hypothermia |
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