AWAreness during REsuscitation - II: A multi-center study of consciousness and awareness in cardiac arrest.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Parnia Sam, Keshavarz Shirazi Tara, Patel Jignesh, Tran Linh, Sinha Niraj, O'Neill Caitlin, Roellke Emma, Mengotto Amanda, Findlay Shannon, McBrine Michael, Spiegel Rebecca, Tarpey Thaddeus, Huppert Elise, Jaffe Ian, Gonzales Anelly M, Xu Jing, Koopman Emmeline, Perkins Gavin D, Vuylsteke Alain, Bloom Benjamin M, Jarman Heather, Nam Tong Hiu, Chan Louisa, Lyaker Michael, Thomas Matthew, Velchev Veselin, Cairns Charles B, Sharma Rahul, Kulstad Erik, Scherer Elizabeth, O'Keeffe Terence, Foroozesh Mahtab, Abe Olumayowa, Ogedegbe Chinwe, Girgis Amira, Pradhan Deepak, Deakin Charles D
Аннотация
METHODS: In a prospective 25-site in-hospital study, we incorporated a) independent audiovisual testing of awareness, including explicit and implicit learning using a computer and headphones, with b) continuous real-time electroencephalography(EEG) and cerebral oxygenation(rSO2) monitoring into CPR during in-hospital CA (IHCA). Survivors underwent interviews to examine for recall of awareness and cognitive experiences. A complementary cross-sectional community CA study provided added insights regarding survivors' experiences.
RESULTS: Of 567 IHCA, 53(9.3%) survived, 28 of these (52.8%) completed interviews, and 11(39.3%) reported CA memories/perceptions suggestive of consciousness. Four categories of experiences emerged: 1) emergence from coma during CPR (CPR-induced consciousness [CPRIC]) 2/28(7.1%), or 2) in the post-resuscitation period 2/28(7.1%), 3) dream-like experiences 3/28(10.7%), 4) transcendent recalled experience of death (RED) 6/28(21.4%). In the cross-sectional arm, 126 community CA survivors' experiences reinforced these categories and identified another: delusions (misattribution of medical events). Low survival limited the ability to examine for implicit learning. Nobody identified the visual image, 1/28(3.5%) identified the auditory stimulus. Despite marked cerebral ischemia (Mean rSO2 = 43%) normal EEG activity (delta, theta and alpha) consistent with consciousness emerged as long as 35-60 minutes into CPR.
CONCLUSIONS: Consciousness. awareness and cognitive processes may occur during CA. The emergence of normal EEG may reflect a resumption of a network-level of cognitive activity, and a biomarker of consciousness, lucidity and RED (authentic "near-death" experiences).