The Evaluation Of Nerval Functional Prognosis In CPR Patients By The Neuromonitoring

Objective: Based on the bedside neuromonitoring in cardiopulmonary cerebralresuscitation patients, such as TCD, NIRS and jugular venous oxygen saturation, toexplore the method and index for evaluating the degree of nerve function damage andprognosis.Materials and Methods: All objects of study came from August2013to March2014in ICU of The Second Hospital Affiliated to Soochow University. The return ofspontaneous circulation study cases were treated in patients after cardiopulmonaryresuscitation. On admission to the ICU, patients admitted to be TCD, NIRS, jugular venousoxygen saturation and other special examination. At the same time they were recorded thechange of vital signs. According to the prognosis of the patients, patients were divided intotwo groups, the improved group, and the poor prognosis group. Through analysis andcomparison of two groups of patients with clinical features, cerebral blood flow andcerebral oxygen metabolism, we were going to explore the relationship between theseindexes and the prognosis of the patients, trying to find a good index to reflect the degreeof brain injury and prognosis.Results:1. Comparing two groups of patients with the gender, age, underlyingdiseases and ICU duration of hospitalization, the difference was not statistically significant(P>0.05). Comparing two groups of patients with clinical signs on admission, thedifference was not statistically significant (P>0.05). Comparing two groups of CA-ROCStime and APACHE II score,the difference was statistically significant (P <0.05).2. In the improved group, the relationship of jugular venous oxygen saturation andregional cerebral oxygen saturation was positively (r=0.738,0.653, P <0.05), in the death group, their relationship was not correlated (r=0.131,0.214, P>0.05). The comparison ofSjvO2between the improved group and death group were statistically significant (t=-3.579,P <0.05), but there were no statistical significance between the two groups of rSO2L,rSO2R (P>0.05).3. The comparison of TCD parameters between the improved group and poor group,the difference was statistically significant (P <0.05).4. The comparison of CMRO2, CBF, a-vDO2in two groups were statisticallysignificant (P <0.05)5. ROC curve analysis revealed: CMRO2, CBF, a-vDO2, SjvO2, r SO2L and r SO2Rcan be used in neural functional prognosis of patients. CMRO2has the highest accuracy forthe evaluation of neural functional prognosis in patients.Conclusions:1. For adult patients with cardiac arrest, the CA-ROCS time andAPACHE II score are important factors to effect neurological prognosis after resuscitation.2. The higher consistency of two types of cerebral oxygen saturation monitoringmethod, the better prognosis of neurological outcome.3. For patients with cardiac arrest, CMRO2, CBF, a-vDO2, SjvO2and r SO2are allassociated with neural functional prognosis. But the index of reflecting the brain tissueoxygenation is CMRO2.