Relationship between time related serum albumin concentration, optic nerve sheath diameter, cerebrospinal fluid pressure, and neurological prognosis in cardiac arrest survivors
| Autor: | Seung Whan Kim, Byung Kook Lee, Seung Ryu, Wonjoon Jeong, Jaein Lee, Yong-Nam In, Insool Yoo, Junwan Lee, Ki Ryang Na, Yongchul Cho, Chihwan Kwack, Jin Hong Min, Sunguk Cho, Hongjoon Ahn, Yeonho You, Jung Soo Park, Se-Kwang Oh, Jin Woong Lee, Dong Hun Lee |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Intracranial Pressure Emergency Nursing Return of spontaneous circulation 03 medical and health sciences 0302 clinical medicine Cerebrospinal fluid Cerebrospinal Fluid Pressure Hypothermia Induced Predictive Value of Tests Internal medicine Outcome Assessment Health Care Humans Medicine Prospective cohort study Serum Albumin Retrospective Studies Intracranial pressure Receiver operating characteristic business.industry Optic Nerve 030208 emergency & critical care medicine Retrospective cohort study Recovery of Function Confidence interval Heart Arrest Emergency Medicine Cardiology Cerebrospinal fluid pressure Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery |
| Zdroj: | Resuscitation. 131:42-47 |
| ISSN: | 0300-9572 |
| Popis: | Aim The optimal time to measure serum albumin concentration (SAC) to predict prognosis in cardiac arrest (CA) survivors has not been elucidated. We aimed to compare the relationships between time-related SAC, optic nerve sheath diameter (ONSD), intracranial pressure (ICP), and neurological prognosis in CA survivors. Methods We undertook a retrospective study examining CA patients treated with target temperature management (TTM). ICP was measured using cerebrospinal fluid (CSF) pressure and ONSD was obtained before TTM. SAC was measured repeatedly at 4–6 h intervals from the hospital arrival time. We analysed CSF pressure, ONSD, and minimum SAC (MSAC) separately, or in combination, to predict poor neurological outcome. Results Of 83 patients enrolled, the good outcome group comprised 25 (34%) patients. MSAC at 24 h (MSAC24) had a higher area under the receiver operating characteristic curve (AUC) (0.687; 95% confidence interval (CI), 0.668–0.926) than other time points. CSF pressure showed a higher AUC (0.973; 95% CI, 0.911–0.996) than MSAC24 and ONSD (0.677; 95% CI, 0.565–0.776). In contrast to using MSAC24 and ONSD separately, the combination of both modalities resulted in a better AUC, thus improving the prediction of the neurological outcome (0.734; 95% CI, 0.626–0.825) and ICP (0.758; 95% CI, 0.651–0.845) after return of spontaneous circulation (ROSC) from CA. Conclusion A higher ICP was strongly associated with and seemed predictive of poor outcome. Furthermore, the MSAC24/ONSD combination may be a useful predictor of high ICP and poor neurological outcome. Prospective studies should be conducted to confirm these results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect