Bradycardia as a sign of outcome in patients after cardiac arrest during targeted body temperature management
10.3760/cma.j.issn.1671-0282.2017.08.022
- VernacularTitle:目标温度管理时心动过缓对心搏呼吸骤停患者预后的评估
- Author:
Peng XU
;
Fei HE
;
Guofeng FAN
;
Jun WANG
- Keywords:
Bradycardia;
Targeted temperature management;
Cardiac arrest;
Cardiopulmonary resuscitation;
Neuron specific enolization enzyme;
Bispectral index;
Cerebral performance category
- From:
Chinese Journal of Emergency Medicine
2017;26(8):939-943
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the association between bradycardia and neurological sequel in patients with restoration of spontaneous circulation (ROSC) after cardiopulmonary resuscitation (CPR) during targeted body temperature management (TTM).Methods Forty-three unconscious patients with ROSC after CPR were treated with TTP.The patients were cooled with therapeutic hypothermia to body temperature target range (32-34°C) after cardiac arrest and divided into bradycardia and control groups depending on the lowest heart rate less than 50 beats/min and more than or equal to 50 beats/min respcetively at that time.The bispectral index (BIS) and the neuron-specific enolase (NSE) values were respectively recorded at the following intervals,0h (h0)、24h (h24)、48h (h48)、72h (h72) after ICU admission.Neurological outcome was defined according to the Pittsburgh cerebral performance category (CPC) at 3 months after ICU discharge.Results Compared with the control group,during TTM the bispectral index levels were significantly higher in the bradycardia group at h0,h48,h72 after admission,(h0 bradycardia group 73.0 ± 12.3;control group 58.0 ± 18.6,P ＜0.01)、(h48 bradycardia group 71.4 ± 21.2;control group 46.3 ± 18.9,P ＜ 0.01)、(h72 bradycardia group 78.6 ± 24.6;control group 51.8 ± 24.1,P =0.01).The neuron-specific enolase level in bradycardia group was significantly lower than that in control group on day3 (118.8 ± 118.8 ng/mL vs.248.3 ± 191.9 ng/mL,P =0.02).The level of CPC in the bradycardia group was significantly higher than that in the control group (P =0.046).Conclusions Patients with bradycardia during TTM had favorable neurological outcome,which could provide evidence for clinical treatment and prognostic evaluation of the patients.
