Document Detail


Cerebral metabolism monitoring during hypothermia following resuscitation from cardiopulmonary arrest.
MedLine Citation:
PMID:  19388317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The aim of the present study was to evaluate cerebral metabolism monitoring during therapeutic hypothermia for global ischemic brain damage after cardiopulmonary resuscitation (CPR). METHODS: Jugular venous sampling and positron emission tomography (PET) were used. Seven comatose patients with cardiopulmonary arrest underwent hypothermia treatment as soon as possible after CPR. The body temperature of these patients was maintained at 34 degrees C for 72 h. Rewarming was performed at a rate of 1 degrees C/day. To monitor jugular venous saturation (SjO2) and lactate (lac-JV), a fiberoptic catheter was inserted into the jugular bulb. Oxygen extraction fraction (OEF) was calculated using the difference between arterial oxygen saturation (SaO2) and SjO2. 18F-fluorodeoxyglucose (FDG) PET was performed to investigate cerebral glucose metabolism at the end of therapeutic hypothermia. FINDINGS: The OEF was significantly increased at the end of hypothermia in four patients with favorable outcome on the Glasgow Outcome Scale (hypothermia onset 15.3 +/- 2.0% vs. hypothermia end 30.3 +/- 2.8%, P < 0.05). In three patients with unfavourable outcome (severe or worse on the Glasgow Outcome Scale), end hypothermia OEF tended to be low. There was also a reduction in FDG uptake in these three patients with unfavourable outcome. The lac-JV was significantly decreased at the end ofhypothermia treatment compared with hypothermia onset (27.7 +/- 7.4 vs. 6.0 +/- 3.0 mg/dL, P < 0.05). CONCLUSIONS: The measurement of cerebral metabolism parameters, especially OEF, might be useful for estimation of hypothermia therapy in patients with unconsciousness after resuscitation after cardiac arrest.
Authors:
Takehiro Nakamura; Yasuhiro Kuroda; Natsuyo Torigoe; Yuko Abe; Susumu Yamashita; Kenya Kawakita; Nobuyuki Kawai; Takashi Tamiya; Toshifumi Itano; Seigo Nagao
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  102     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  2008  
Date Detail:
Created Date:  2009-04-24     Completed Date:  2009-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  Austria    
Other Details:
Languages:  eng     Pagination:  203-6     Citation Subset:  IM    
Affiliation:
Department of Neurobiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki, Kita, Kagawa 761-0173, Japan. tanakamu@kms.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain / metabolism*,  radionuclide imaging
Cardiopulmonary Resuscitation / methods*
Child
Female
Fluorodeoxyglucose F18 / diagnostic use
Heart Arrest / pathology*,  radionuclide imaging,  therapy*
Humans
Hypothermia, Induced / methods*
Jugular Veins / metabolism
Male
Middle Aged
Monitoring, Physiologic*
Oxygen / metabolism
Positron-Emission Tomography / methods
Retrospective Studies
Chemical
Reg. No./Substance:
63503-12-8/Fluorodeoxyglucose F18; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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