ACLS 2005 3 5 ACLS 2010 5 Post
- Slides: 53
救命の連鎖 ACLS 2005 3
第 5の鎖 ACLS 2010 第 5の鎖:心拍再開後の集中治療 Post Cardiac Arrest Syndrome 4
Outcome • Discharge:退院 • Mortality:死亡率 • Neurogenic outcome:神経学的予後 • Cerebral Performance Category • CPC 1. 2 (GOOD) VS CPC 3. 4. 5(POOR)
GOOD POOR
Prognosis of PCAS
CT
-Landmark Reviewin 2006 • From American Academy of Neurology (AAN) • 自己心拍再開後72時間以内の予後不良因子 – Day 1 • Myoclonus Status epileptics – Day 1 -3 • SSEPsにおける両側N 20 waveの消失 • NSE>33μg/L – Day 3 • 両側対光反射・角膜反射消失 • M1−2 However, these recommendations need updating
-Landmark Reviewin 2006 • From American Academy of Neurology (AAN) • 自己心拍再開後72時間以内の予後不良因子 代 時 – Day 1 前の 以 る す • Myoclonus Status epileptics 及 普 が – Day 1 -3療法 温 体 低 • SSEPsにおける両側N 20 waveの消失 • NSE>33μg/L – Day 3 • 両側対光反射・角膜反射消失 • M1−2 However, these recommendations need updating
Intensive Care Med (2014) 40: 1816– 1831
Intensive Care Med (2014) 40: 1816– 1831
Classification 筋収縮( Myoclonic jerk) Myoclonus Status Myoclonus ・全般化 ・少なくとも30分継続 with epileptic activity Myoclonus status epilepticus no epileptic activity
SPIKE & WAVE http: //www. scielo. br/scielo. php? pid=S 0004 -282 X 200700036&script=sci_arttext
BURST & SUPRESSION
PED periodic epileptifom discharge
DATA Collection MyoclonusとStatus myoclonusとLance-Adams Syndrome • 出現のタイミング、持続時間、症状の部位は 記録されていない • MyoclonusとStatus myoclonusと Lance-Adams Syndrome の区別は本研究では ついていない
Outcome Measurement • Primary outcome –退院時の神経学的予後 • Cerebral Performance Category
Primary Outcome n=31 Fig 1
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