脑电双频指数对心肺复苏术后患者预后的评估

The prognostic value of bispectral index in patients with acute cardiopulmonary resuscitation

目的探讨脑电双频指数（BIS）对心肺复苏术后患者预后的评估价值。方法收集33例心肺复苏术后患者，根据其复苏结果（7d生存率）分为存活组和死亡组。入ICU行BIS持续监测，同时记录格拉斯哥昏迷评分（GCS）及急性生理健康与慢性疾病评分（APACHE．Ⅱ），监测所有患者动脉氧饱和度（SaO2），对其中23例进行颅底静脉氧饱和度（SjO2）监测，取两者差值（SaO2-SaO2）来反映脑氧代谢状况。比较两组BIS值、SjO2值、SaO-SjO2差值，BIS与GCS评分、APACHE—II评分的相关性。结果存活组和死亡组BIS值比较，差异具有统计学意义（P〈0．01）；两组SaO2-SjO2差值比较，差异具有统计学意义（P〈0．01）；BIS与GCS评分具有良好的相关性（r=0．821，P〈0．01）；BIS与APACHE-Ⅱ评分亦具有相关性（r=0．434，P〈0．05）。结论BIS值持续监测在一定程度上反映患者的预后，与SaO2-SjO2差值相结合对心肺复苏术后患者预后的评估更有价值。

Objective To evaluate the prognostic role of bispectral index （BIS） monitoring in patients after eardiopulmonary resuscitation （CPR） in the intensive care unit （ICU）. Methods Thirty- three adult patients after CPR were enrolled and divided into survived group and non - survived group as per 7-day survival. During their stay in the ICU, BIS and SaO2 （saturation of artery oxygen） levels of all the patients were continuously monitored. The neurological status of the patients was measured with Glasgow coma scale （GCS）. Acute physiology and chronic health evaluation 1[ （APACHE 11 ） was used to evaluate the patient condition. SjO2 （saturation of jugular bulb venous oxygen ） levels of 23 patients were continuously monitored and then the difference in values between SaO2 and SjO2 was calculated to show oxygen metabolism in the brain. The studied variables were compared between the two groups. The correlations between BIS values and GCS scores, and between BIS and APACHE II scores were respectively analyzed. Results The BIS values and difference in values between the SaO2 and SjO2 were significantly higher in the patients of survived group than those in the patients of non-survived group （P 〈0. 01 ）. There were positive correlation between BIS and GCS （ r = 0. 821, P 〈 0. 01 and as well as positive correlation between BIS and APACHE- 11 （ r = 0. 434, P 〈 O. 05 ）. Conclusions The BIS may be useful to predict the post - resuscitative outcome of patients after cardiopulmonary resuscitation.