0000000000083834
AUTHOR
Sacha L. Weilemann
Poor prognosis despite successful treatment of postanoxic generalized myoclonus.
Generalized myoclonus (GM) after cardiopulmonary resuscitation (CPR) implies a poor prognosis.1 Postanoxic GM is usually classified as one type of convulsive status epilepticus,2 which is also reflected by terms like myoclonic status,3 myoclonic status epilepticus,4 or postanoxic status epilepticus.5 Antiepileptic drugs commonly used in the treatment of status epilepticus such as phenytoin or valproate, however, are ineffective in the majority of these patients.3,4,6 Reports of single patients7 and our own observations6 indicated that propofol may control GM. This prompted us to use propofol as standard treatment of postanoxic GM in 60 consecutive comatose survivors of CPR. ### Level of evi…
The temporal dynamics of postanoxic burst-suppression EEG.
Burst-suppression EEG (BS-EEG) after cardiopulmonary resuscitation implies a bad prognosis, but little is known of the temporal dynamics of postanoxic BS-EEG. The authors studied 24 consecutive patients who developed BS-EEG within 24 hours after cardiopulmonary resuscitation, and followed 20 of these patients with serial EEGs. Except for one patient, BS-EEG was followed by another EEG pattern within 1 day, mainly areactive alpha EEG (n = 6), isoelectric EEG (n = 5), generalized continuous epileptiform discharges (n = 4), or theta; EEG (n = 3). The coexistence of different EEG patterns in the same recording was seen in 10 patients. Serial recordings disclosed a variety of EEG sequences with …
Inhomogenität der linksventrikulären Kontraktion unter der Beatmung mit positiv-endexspiratorischem Druck
Anhand dieser Untersuchung sollte die Auswirkung der Beatmung mit positivem enddiastolischem Druck auf das regionale Kontraktionsverhalten des linken Ventrikels mittels transosophagealer echokardiographischer Messungen gezeigt werden. Das Kollektiv bestand aus 17 intensivpflichtigen Patienten, die wegen einer akuten respiratorischen Insuffizienz beatmet werden musten. Bei allen Patienten wurden fortlaufende transosophageale Querschnittsmessungen des linken Ventrikels in der kurzen Achse unter ZEEP (Zero End-Expiratory Pressure), dann uber 5 min unter PEEP 16 und anschliesend wieder uber 5 min nach Abschalten von PEEP 16 cm H2O registriert. Bei funf Patienten wurde der gleiche Mesvorgang auc…