Еще, недавняя неплохая статья в полной версии, что делается, чтобы улучшить исход; выживаемость от 13 до 28% в зависимости от исходного состояния/диагноза пациента:
Crit Care Med. 2008 Nov;36(11 Suppl):S397-404.
From laboratory science to six emergency medical services systems: New understanding of the physiology of cardiopulmonary resuscitation increases survival rates after cardiac arrest.
[Ссылки доступны только зарегистрированным пользователям ]
---
совсем свежая публикация, что оценка Regional cerebral oxygen saturation быть может поможет оценить благоприятный неврологический исход после СРЛ; выживаемость с хорошим неврологическим исходом 14%:
Resuscitation. 2012 Jan;83(1):46-50.
Regional cerebral oxygen saturation on hospital arrival is a potential novel predictor of neurological outcomes at hospital discharge in patients with out-of-hospital cardiac arrest.
Ito N, Nanto S, Nagao K, Hatanaka T, Nishiyama K, Kai T.
Senri Critical Care Medical Center, Osaka Saiseikai Senri Hospital, 1-1-6 Tsukumodai, Suita, Osaka 565-0862, Japan.
AIM: To investigate the association between regional brain oxygen saturation (rSO(2)) on hospital arrival and neurological outcomes at hospital discharge in patients with out-of-hospital cardiac arrest (OHCA).
METHODS: A prospective cohort study was conducted, registering 179 patients with OHCA who were referred to Senri Critical Care Medical Centre between April 2009 and June 2010. Of these patients, 92 met the inclusion criteria. The primary end point was "neurological outcomes" at hospital discharge according to the "Utstein style" guidelines.
RESULTS: The overall rate of good neurological outcome at hospital discharge was 14% (n=13). Sixty-one patients with rSO(2) ≤25% showed poor neurological outcome in the receiver operating curve analysis (optimal cut-off point, 25%; sensitivity, 0.772; specificity, 1.000; positive predictive value, 1.000; area under the curve (AUC), 0.919; p<0.0001). The AUC for rSO(2) was greater than that for base excess (p=0.0461) or lactate (p=0.0128) measured on hospital arrival. Since rSO(2) >40% was previously collated with good neurological outcome after cardiovascular surgery, we categorised our patients into three groups in a post hoc analysis: patients with rSO(2) ≤25% (n=61); patients with rSO(2) 26-40% (n=9) and patients with rSO(2) >40% (n=22). Patients with good neurological outcome were as follows: 0 (0%)/61 with rSO(2) ≤25%; two (22.2%)/9 with rSO(2) 26-40% and 11 (50.0%)/22 with rSO(2) >40% (p<0.0001).
CONCLUSION: rSO(2) on hospital arrival may help predict neurological outcomes at hospital discharge in patients with OHCA.
и ред. комментарий к ней:
Resuscitation. 2012 Jan;83(1):11-2.
Cerebral oximetry - the holy grail of non-invasive cerebral perfusion monitoring in cardiac arrest or just a false dawn?
Parnia S.
|