Acute brain swelling after out-of-hospital cardiac arrest
| Autor: | Izumi Matsubara, Yuji Morimoto, Ichiro Tedo, Osamu Kemmotsu, Koichi Kitami |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Male Resuscitation Heart Diseases Intracranial Pressure Brain Edema Critical Care and Intensive Care Medicine Group A Group B Pathogenesis Humans Medicine Hypoxia Aged Acidosis Respiratory distress business.industry Middle Aged Prognosis Respiration Disorders medicine.disease Heart Arrest Treatment Outcome Anesthesia Lactic acidosis Acute Disease Etiology Female medicine.symptom Tomography X-Ray Computed business |
| Zdroj: | Critical Care Medicine. 21:104-110 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-199301000-00020 |
| Popis: | Objectives First, to examine factors that may be related to brain swelling, which was identified by the absence or compression of the lateral and third ventricles and perimesencephalic cisterns on brain computed tomography (CT) scans in the early postresuscitation period in patients who suffered an out-of-hospital cardiac arrest. Second, to characterize the neurologic outcome in those patients in whom cardiac arrest was followed by brain swelling. Design Prospective and retrospective analyses. Settings General ICU, tertiary care hospital. Patients Fifty-three patients (35 male, 18 female) who had an out-of-hospital cardiac arrest and who also had a brain CT examination on the third day after resuscitation. The 53 patients were divided into two groups: group A (25 patients) experienced brain swelling on postresuscitation day 3; group B (28 patients) did not experience noticeable brain swelling. Interventions None Measurements and Main Results There was a significant difference between the two groups in the etiology of the cardiac arrest. Twenty-three of 25 patients in group A had cardiac arrest due to respiratory distress, whereas this finding was true in only five patients in group B. In laboratory data, arterial pH was significantly lower in group A than in group B (6.93 vs. 7.09), as was base deficit (-21.0 mmol/L in group A vs. −13.7 mmol/L in group B). Neurologic outcome was evaluated 1 wk after resuscitation. There were significantly more patients in group A who were not awake and who were diagnosed as braing dead. Conclusions The cause of brain swelling may be related to the development of the metabolis acidosis (possibly lactic acidosis) due to hypoxie before the resuscitation period. Brain swelling may be one of the indicators that predicts a poes neurologic outcome in the patients who suffes an out-of-hospital cardiac arrest. (Crit Care Med 1993; 21:104–110) |
| Databáze: | OpenAIRE |
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