A primary intracranial event leading to cardiac arrest (e.g. subarachnoid > 자유게시판

A primary intracranial event leading to cardiac arrest (e.g. subarachnoid hemorrhage) or when clinical findings suggested intracranial complications (e.g. intracranial hemorrhage during anticoagulant therapy for myocardial infarction). Thirteen patients were excluded from further analysis for findings that would have biased measurement of Hounsfield units and GWR calculation (only contrastOnly non-contrast enhanced CT scans were analyzed. CT scans were acquired on three different GE scanners (GE LightSpeed Pro 16 (n = 78), Lightspeed Ultra (n = 7), Lightspeed VCT (n = 13)-GE Healthcare, Little Chalfont, UK). All examinations followed a standard head CT protocol with a slice thickness of 5 mm. For assessment of inter-raterreliability, ROIs were determined independently by two raters. ROIs were placed and GWR scores calculated according to criteria described previously [17]. The ROIs consisted of circular shaped areas (0.1 cm2) placed bilaterally in caudate nucleus (CN),Table 1 Demographic data given as absolute numbers and percent or median and interquartile range (IQR)Demographics of study population Age (years) Female sex APACHE Score Out-of-hospital Primary cause of arrest Cardiac Respiratory Other Shockable rhythm Time to ROSC (min) Total epinephrine dose (mg) Length of ICU stay (days) Time on ventilator (hours) Neurological outcome CPC 1 CPC 2 CPC 3 CPC 4 CPC 5 23 (23.5 ) 14 (14.3 ) 2 (2.0 ) 9 (9.2 ) 50 (51 ) 52 (53 ) 41 (42 ) 5 (5 ) 29 (29.6 ) 14.5 (10?6) 2 (0.7?.0) 11.5 (5?8) 205 (109?21.2) 61 (47?2.2) 33 (33.7 ) 30 (23.5?6) 81 (82.7 )APACHE: Acute Physiology and Chronic Health Evaluation, AMI: acute myocardial infarction, ROSC: return of spontaneous circulation, ICU: intensive care unit, CPC: cerebral performance category.Scheel et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2013, 21:23 http://www.sjtrem.com/content/21/1/Page 3 ofputamen (PU), thalamus (THL), posterior limb of internal capsule (PIC), forceps minor of the corpus callosum (CC), medial cortex (MC1) and medial white matter (MWM1) at the level of the centrum semiovale and high convexity area (MC2 and MWM2, respectively). Both raters were blind to clinical information and outcome of all patients as well as ROI placement and GWR scores of each other. GWR in the basal ganglia was calculated as GWR-BG = (CN + PU) / (CC + PIC). GWR at the cortical level was calculated as GWR-CE = (MC1 + MC2) / (MWM1 + MWM2). Average GWR was defined as the average of these two GWR-AV = (GWR-BG + GWR-CE)/2 [17].Neuron specific enolase and somatosenCapivasertibCapivasertib Abstract(s)">PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/16989806 time between cardiac arrest and CCT, we divided all patients with poor outcome into three groups (CCT 24 h after cardiac arrest). GWR values of these three groups were compared by using a Kruskal-Wallis test.ResultsAssociation of GWR and clinical outcomeNSE serum levels were determined in 84 out of 98 patients as described in an earlier study [2]. We have previously found a cut-off value of 78.9 g/L for poor outcome prediction with 100 specificity [2], and a cutoff value of 81.8 g/L has recently been reported by a large prospective multicenter study [6]. To our knowledge, the highest NSE cut-off value reported is 97 g/L [3]. We therefore applied this limit to the current study and have implemented it in our diagnostic pathway [19]. For 67 out of 98 patients results of SSEP were available. SSEPs were performed with stimulation of the med.