- 作者：Zingler ; Vera Carina ; Pohlmann-Eden ; Bernd
- 刊名：Resuscitation
- 出版年：2005
- 期刊代码：236_03009572
- 类别：med
- 出版时间：April, 2005
- 卷：65
- 期：1
- 页码：107-110
- 文件大小：59.2 K
Objective:Our aim was to assess the possible diagnostic pitfalls in three patients with hypoxic brain damage who had partly conflicting clinical, biochemical, and electrophysiological data and were in a persistent vegetative state (PVS) following cardiac arrest (CA).Methods:
Serum concentrations of the destruction proteins, neuron-specific enolase (NSE) and protein S-100B (S-100B), were measured on days 1–3, and 7; somatosensory evoked potentials (SEPs) were recorded within 48 h and on day 7 after CA.
Results:
Two patients had significantly increased concentrations of NSE and S-100B during the first 3 days after CA, a finding that indicates ongoing neuronal destruction. In contrast, the SEPs of these patients were normal or showed only a diminished amplitude configuration. In the third patient the SEPs demonstrated a bilateral loss of cortical responses repeatedly, but both destruction proteins were only slightly above the upper normal values on all study days.
Conclusion:
Our findings demonstrate that a poor prognosis can only be established if either SEPs, NSE, or S-100B are very abnormal. The conflicting results in our patients indicate that variable values may reflect different patterns of neuropathological damage caused by diffuse hypoxia. We, therefore, favour a multi-modal approach with a combination of clinical, biochemical, and electrophysiological investigations in order to predict neurological outcome after CA reliably.