Evaluation of Prognosis of Brain Function with Early Transcranial Color Doppler Ultrasound in Patients after Cardiopulmonary Resuscitation

摘要

Objective : To evaluate the clinical value of transcranial color Doppler ultrasound (TCCD) in assessing cerebral function after cardiopulmonary resuscitation (CPR). Methods : A prospective study was conducted in 52 patients with cardiac arrest treated by CPR from January 2018 to January 2020, and its clinical data were analyzed . According to classification of cerebral performance category (CPC), 31 cases (CPC grade 1 - 2) were selected in the good prognosis group and 21 cases (CPC grade 3 - 5) in the poor prognosis group. The cerebral blood flow was measured by transcranial Doppler ultrasound (TCCD) 24 h after CPR, and the differences were compared between the two groups in stroke index, diastolic blood flow velocity (Vd), systolic peak blood flow velocity (Vs) and mean peak blood flow velocity (Vm). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function. Results : The data showed that the pulsatility index of middle cerebral artery of the poor prognosis group decreased within 24 h ; the difference between the two groups was statistically significant (p < 0.05); the Vd, Vs, Vm increased in the good prognosis group ; the difference between the two groups was statistically significant (p < 0.05). The ROC curve of cerebral blood flow after CPR was drawn to predict the prognosis of brain function, and the results showed that the area under the curve and the optimal critical value of cerebral blood flow were 0.731 and 5.69. The sensitivity and specificity were 67.3% and 79.1% respectively. Conclusion : The cerebral blood flow increase in the early stage of successful CPR is positively correlated with the prognosis of cerebral functional resuscitation. Monitoring intracranial blood flow after CPR by TCCD has clinical value to evaluate prognosis of brain function.