THE ROLE OF COMPUTERIZED BRAIN TOMOGRAPHY IN DETERMINING THE PROGNOSIS IN CASES WITH CARDIOPULMONARY ARREST AND RETURN OF SPONTANEOUS CIRCULATION IN THE EMERGENCY DEPARTMENT

Year 2020, Volume: 21 Issue: 2, 169 - 175, 11.05.2020

Tamer Çolak , Mustafa Hızal

https://doi.org/10.18229/kocatepetip.532021

Abstract

OBJECTIVE: We aimed to evaluate the role of computed brain tomography in determining the patient's prognosis after spontaneous circulation who were treated with cardiopulmonary arrest in the emergency department.
MATERIAL AND METHODS: We retrospectively evaluated 28 patients with cardiopulmonary arrest. Patients' demographic information, location of arrest, arrest etiology, duration of cardiopulmonary resuscitation, survival time and glasgow outcome scale, computerized brain tomography findings and time of shooting were evaluated.
RESULTS: Patients were divided into two groups according to their life expectancy: those who live less than 30 days (group 1) and those who live more than 30 days (group 2). At the end of the first month, 13 (46.43%) patients were alive. Six (46.15%) of the survivors had good neurological results. In the patients who died in the first month of the computerized brain tomography, the rate of hypodensity was low while the gray-white matter evanescence was 80% in the basal ganglion level and 100% in the upper levels. Tomography revealed hypoxia in all patients with out-of-hospital cardiac arrest and 70% of patients with in-hospital-cardiac arrest had hypoxia.
CONCLUSIONS: In addition to hypodensity on computed brain tomography following cardiac arrest, gray-white matter evanescence and levels can be estimated in terms of survival and prognosis.

Keywords

Cardiopulmonary arrest, computed brain tomography, prognosis

ACİL SERVİSE KARDİYOPULMONER ARREST NEDENİYLE GETİRİLEN VE SPONTAN DOLAŞIMI GERİ DÖNEN OLGULARDA ÇEKİLEN BİLGİSAYARLI BEYİN TOMOGRAFİNİN PROGNOZU BELİRLEMEDEKİ YERİ

Abstract

AMAÇ: Acil serviste kardiyopulmoner arrest nedeniyle müdahale edilen hastalarda, spontan dolaşımın sağlanması sonrası çekilen bilgisayarlı beyin tomografinin hasta prognozunu belirlemedeki yerini değerlendirmeyi amaçladık.
GEREÇ VE YÖNTEM: Çalışmamız, 28 kardiyopulmoner arrest hastası ile retrospektif olarak yapıldı. Hastaların demografik bilgileri, arrest yeri, arrest etyolojisi, kardiyopulmoner resüsitasyon süresi, sağ kalım süresi ve Glasgow Sonlanım Skalası, bilgisayarlı beyin tomografisi bulguları ve çekim zamanı değerlendirildi.
BULGULAR:Hastalar yaşam sürelerine göre 30 günün altında yaşayanlar (1. grup) ve 30 günün üzerinde yaşayanlar (2.grup) olarak iki gruba ayrıldı. 1.ayın sonunda 13 (%46.43) hasta sağ kaldı. Sağ kalan hastaların 6 (%46.15)’sı iyi nörolojik sonuca sahipti. İlk bir ay içerisinde ölen hastalarda bilgisayarlı beyin tomografide hipodansite görülme oranı düşük iken gri-beyaz cevher silinmesi görülme oranı bazal ganglion düzeyinde %80 ve daha üst seviyelerde %100’dü. Hastane dışı arrest olan hastaların tümünde tomografide hipoksi bulgusu saptanırken hastane içinde arrest olan hastaların %70’inde hipoksi bulgusu vardı.
SONUÇ: Kardiyak arrest sonrası bilgisayarlı beyin tomografide görülen hipodansiteye ek olarak gri-beyaz cevher silinmesi ve seviyeleri değerlendirildiğinde sağ kalım ve prognoz açısından tahmin yapılabilir.

Keywords

Kardiyopulmoner Arrest, Bilgisayarlı Beyin Tomografi, prognoz

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