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neurological outcomes of patients admitted to the intensive care unit for cardiac arrest

Chinese Medical Journal 2014年第16期127卷 3024-3026页

作者： Liu Lijun Zhu Jianliang Yang Lin Zhang Yan Department of Emergency and Critical Care Medicine Second Affiliated Hospital of Soochow University Suzhou Jiangsu 215004China

Cardiac arrest （CA） is a major cause of death, with an estimated 300 000 cases of out-of-hospital CA reported in Europe and the United States each year. Advances in resuscitation techniques have improved survival such that approximately one-third of patients achieve return of spontaneous circulation （ROSC）. Nonetheless, only between half and one-third of patients who have achieved ROSC survive until discharge.

关键词： cardiac arrest neurological outcome risk factors multivariate analysis

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outcome of bystander cardiopulmonary resuscitation after out-of-hospital cardiac arrest in Beijing

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Emergency and Critical Care Medicine 2021年第2期1卷 64-69页

作者： Xian Shi Yang Wu Haibin Li Shengkui Ma Dou Li Ding Gao Hao Cui Changxiao Yu Song Yang Ziren Tang Fei Shao Department of Emergency Medicine Beijing Huairou HospitalBeijingChina Department of Emergency Medicine Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Heart Center&Beijing Key Laboratory of Hypertension Beijing Chaoyang HospitalCapital Medical UniversityBeijingChina Beijing Red Cross Emergency Rescue Center BeijingChina Beijing Emergency Medical Center BeijingChina Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation BeijingChina

Aim:We aimed to investigate the association between bystander cardiopulmonary resuscitation(CPR)and survival of patients with out-of-hospital cardiac arrests(OHCA)in ***:This observational study analyzed adult patients with OHCA treated by the Beiing emergency medical service(EMS)from January 2013 to December *** were collected in a Utstein style with a 1-year follow-up and a primary outcome 01 survival to hospital *** outcomes were return of spontaneous circulation(ROSC),survival to admission,favorable neurological outcome at hospital discharge,and survival and favorable neurological outcomes of up to 1 ***:A total of 5016 patients with OHCA from Beiing's urban area were recorded by EMS,wherein 765 patients(15.25%)underwent bystander *** data were propensity score-matched forage,sex,location,witness,aetiology,initial rhythm,and call to EMS arrival to compare the difference between the occurrence and nonoccurrence of bystander *** survival upon the discharge of patients who experienced bystander CPR was superior to that of patients who did not receive bystander CPR(3.7%vs 1.2%,respectively;Poutcomes of ROSC,survival to admission,favorable neurological outcome at hospital discharge,survival and favorable neurological outcome after 1 year compared with those who were not resuscitated with bystander ***:Survival and neu rological outcome of patients who underwent bystander CPR was better than those who underwent nonbystander CPR in ***,the rate of bystander CPR was low.

关键词： Bystander cardiopulmonary resuscitation Emergency medical service neurological outcome Out-of-hospital cardiac arrest Survival

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Neurodevelopmental outcome of Newborns Aged More than 34 Weeks Gestational Age Managed for Birth Asphyxia in Douala (Cameroon): A Single Hospital-Based Study

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Open Journal of Pediatrics 2023年第6期13卷 838-851页

作者： Diomède Noukeu Njinkui Dominique Enyama Yolande Djike Fokam Danie L. Nanga Mewolo Christelle Annick Ngo Kana Sylvain Raoul Simeni Njonnou Charlotte Eposse Ekoube Arielle Annick Sime Tchouamo Paul Olivier Koki Ndombo Danièle-Christiane Kedy Koum Faculty of Medicine and Pharmaceutical Sciences University of Dschang Dschang Cameroon Douala Gynaeco-Obstetric and Pediatric Hospital Douala Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Yaoundé Gynaeco-Obstetric and Pediatric Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon

Background: Perinatal asphyxia is a common cause of mortality and of morbidity including motor and neurodevelopmental abnormalities. The aim of this study was to evaluate the post-hospital outcome of neonates treated for perinatal asphyxia at the Douala Gynaeco-Obstetric and Pediatric Hospital (DGOPH) in Cameroon. Patients and Methods: We conducted a hospital-based cross-sectional study with both a retrospective and prospective data collection, conducted over a period of 3 months and involving neonates above 34 weeks of gestational age who were managed for perinatal asphyxia at DGOPH from August 2015 to February 2020. Socio-demographic, perinatal, motor, nutritional and neuro-developmental out-of-hospital data were recorded. The assessment of the child’s psychomotor development was evaluated through gross motor skills, fine motor skills, language and social contact. We calculated the development quotient (DQ) by dividing the developmental age (DA) by the actual age (RA) of the patient. The data were entered and analyzed using excel and Stata version 15 software. Results: Among the 58 newborns included in our study, males were the most represented (59%). The mean age was 36.5 ± 14.16 months (Extremes: 12 months and 66 months). The majority of patients were born at term (79%), had a birth weight between 2500 and 4000 grams (69%), were resuscitated (95%), and had an Apgar score th minute of life (67%). SARNAT stages II and III counted for 48%. Neurodevelopmental abnormalities were found in 25.5% of patients with gross motor delay (mainly tetraparesis) representing 23.5%, fine motor delay 27.5%, impairment in social contact 31% language speech delay. The majority of the children had a normal development quotient (78.4%). Conclusion: The short-term and long-term outcome of newborns who experienced perinatal asphyxia in our setting is marked by numerous impairments in developmental milestones leading to disability.

关键词： Perinatal Asphyxia Newborn neurological outcome Cameroon

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Short and long term prognosis in perinatal asphyxia: An update

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World Journal of Clinical Pediatrics 2016年第1期5卷 67-74页

作者： Caroline E Ahearne Geraldine B Boylan Deirdre M Murray Department of Paediatrics and Child Health University College Cork Irish Centre for Fetal and Neonatal Translational Research (INFANT Centre) University College Cork

Interruption of blood flow and gas exchange to the fetus in the perinatal period, known as perinatal asphyxia, can, if significant, trigger a cascade of neuronal injury, leading on to neonatal encephalopathy(NE) and resultant long-term damage. While the majority of infants who are exposed to perinatal hypoxia-ischaemia will recover quickly and go on to have a completely normal survival, a proportion will suffer from an evolving clinical encephalopathy termed hypoxic-ischaemic encephalopathy(HIE) or NE if the diagnosis is unclear. Resultant complications of HIE/NE are wide-ranging and may affect the motor, sensory, cognitive and behavioural outcome of the child. The advent of therapeutic hypothermia as a neuroprotective treatment for those with moderate and severe encephalopathy has improved prognosis. outcome prediction in these infants has changed, but is more important than ever, as hypothermia is a time sensitive intervention, with a very narrow therapeutic window. To identify those who will benefit from current and emerging neuroprotective therapies we must be able to establish the severity of their injury soon after birth. Currently available indicators such as blood biochemistry, clinical examination and electrophysiology are limited. Emerging biological and physiological markers have the potential to improve our ability to select those infants who will benefit most from intervention. Biomarkers identified from work in proteomics, metabolomics and transcriptomics as well as physiological markers such as heart rate variability, EEG analysis and radiological imaging when combined with neuroprotective measures have the potential to improve outcome in HIE/NE. The aim of this review is to give an overview of the literature in regards to short and longterm outcome following perinatal asphyxia, and to discuss the prediction of this outcome in the early hours after birth when intervention is most crucial; looking at both currently available tools and introducing novel

关键词： Perinatal asphyxia neurological outcome Hypoxic ischaemic encephalopathy Cerebral palsy Cognitive outcome

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