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Amplitude-Integrated Electroencephalography Predicts Outcome in Patients with Coma After acute brain injury

Neuroscience Bulletin 2018年第4期34卷 639-646页

作者： Wendong You Qilin Tang Xiang Wu Junfeng Feng Qing Mao Guoyi Gao Jiyao Jiang Department of Neurosurgery Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Shanghai Institute of Head Trauma Shanghai 200127China

Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography （aEEG） for neurological outcomes in coma patients. From January 2013 to January 2016, 128 coma patients after acute brain injury were prospectively enrolled and monitored with aEEG. The 6-month neurological outcome was evaluated using the Cerebral Performance Category Scale. aEEG monitoring commenced at a median of 7.5 days after coma onset. Continuous normal voltage predicted a good 6-month neurological outcome with a sensitivity of 93.6% and specificity of 85.2%. In contrast, continuous extremely low voltage, burst-suppression, or a flat tracing was correlated with poor 6-month neurological outcome with a sensitivity of 76.5% and specificity of 100%. In conclusion, aEEG is a promising predictor of 6-month neurological outcome for coma patients after acute brain injury.

关键词： Amplitude-integrated electroencephalography -Coma acute brain injury Outcome

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The electrocardiographic changes in acute brain injury patients

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Chinese Medical Journal 2012年第19期125卷 3430-3433页

作者： FAN Xin DU Feng-he TIAN Jun-ping Division of Cardiology Beijing Tiantan HospitalCapital Medical UniversityBeijing 100050China

Background Electrocardiographic （ECG） changes occurring during the course of acute brain injury （ABI） have been described frequently, but their significances remain uncertain. The present study was designed to investigate the relation of ECG abnormalities to outcome in the patients with ABI. Methods We performed a retrospective, observational study on the ABI patients admitted to the Department of Neurosurgery of the Beijing Tiantan Hospital between December 2005 and December 2007. All the patients accepted 12-lead electrocardiographic examination within 24 hours after injury, then divided into three groups according to the Glasgow coma score （GCS）. In-hospital mortality and one-month outcome assessed by the Glasgow outcome score （GOS） were investigated. Results Of 335 ABI patients （mean ages 32.4 years）, 246 patients （73.4%） had abnormal ECGs. The most common abnormality was ST-T changes （41.5%）, followed by sinus tachycardia （23.6%）. ECG changes had a significant association with the severity and outcome. Logistic regression analysis showed the presence of ST-T changes （OR 2.587, 95%C/1.009 to 6.629, P=0.048） and QT dispersion prolongation （OR 4.656, 95%C/1.956 to 11.082, P=0.001） significantly associated with short outcomes. Conclusions ABI can lead to myocardial damage and ECG changes had a significant association with the severity. ST-T changes and QT dispersion prolongation were the independent prognosis factors for the negative outcome of ABI patients.

关键词： acute brain injury electrocardiographic abnormalities outcome

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Effects of positive end-expiratory pressure on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in acute brain injury:Friend or foe?A scoping review

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Journal of Intensive Medicine 2024年第2期4卷 247-260页

作者： Greta Zunino Denise Battaglini Daniel Agustin Godoy IRCCS Ospedale Policlinico San Martino GenovaItaly Dipartimento di Scienze Diagnostiche e Chirurgiche Integrate Universitàdegli Studi di GenovaGenovaItaly Neurointensive Care Unit Sanatorio PasteurCatamarcaArgentina

Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk *** patients often require mechanical ventilation(MV)to avoid the complications of impaired respiratory function that can follow ABI;MV should be settled with meticulousness owing to its effects on the intracranial compartment,especially regarding positive end-expiratory pressure(PEEP).This scoping review aimed to(1)describe the physiological basis and mechanisms related to the effects of PEEP in ABI;(2)examine how clinical research is conducted on this topic;(3)identify methods for setting PEEP in ABI;and(4)investigate the impact of the application of PEEP in ABI on the *** The five-stage paradigm devised by Peters et *** expanded by Arksey and O'Malley,Levac et al.,and the Joanna Briggs Institute was used for *** also adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)extension *** criteria:we compiled all scientific data from peer-reviewed journals and studies that discussed the application of PEEP and its impact on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in adult patients with *** criteria:studies that only examined a pediatric patient group(those under the age of 18),experiments conducted solely on animals;studies without intracranial pressure and/or cerebral perfusion pressure determinations,and studies with incomplete *** authors searched and screened for inclusion in papers published up to July 2023 using the PubMed-indexed online *** were presented in narrative and tubular *** The initial search yielded 330 references on the application of PEEP in ABI,of which 36 met our inclusion *** has recognized beneficial effects on gas exchange,but it produces hemodynamic changes that should be predicted to avoi

关键词： acute brain injury Mechanical ventilation Positive end-expiratory pressure Intracranial pressure brain-lung crosstalk Multimodal monitoring

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The effects of lysed erythrocytes on brain injury after Intraventricular hemorrhage

The effects of lysed erythrocytes on brain injury after Int...

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2011中华医学会神经外科学学术会议

作者： Chao Gao1 Ya Hua2 Guohua Xi2 1.Department of Neurosurgery, Huashan hospital, Fudan University 2.Department of Neurosurgery, University of Michigan

Background and purpose Intraventricular hemorrhage (IVH) occurs in up to 50% of patients with primary intracerebral hemorrhage (ICH) and 45% of patients with aneurysmal subarachnoid hemorrhage (SAH). The current resea... 详细信息

关键词： intraventricular hemorrhage deferoxamine hydrocephalus acute brain injury erythrocyte lysis iron

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