不同时间测量视神经鞘直径评估心搏骤停患者神经功能预后的价值

Objective: This study aimed to investigate the value of measuring optic nerve sheath diameter(ONSD) at different times after the return of spontaneous circulation (ROSC) in evaluating the neurological function prognosis of post-CA patients. Methods: This was a prospective observational study. Comatose patients successfully resuscitated from CA and transferred to the ICU in Wenzhou Traditional Chinese Medicine and Western Medicine Combined Hospital from March 2021 to June 2024 were selected as the research subjects. The ONSD of the patients was measured using ultrasonography at the initial, 12～24 hours, day 2, and day 3 after ROSC. Based on the Cerebral Performance Categories (CPC) at three months post-treatment, the patients were categorized into two groups: the poor outcome group (CPC 3～5 points) and the good outcome group (CPC 1～2 points). The Receiver operating characteristic curves of the subjects were plotted to compare the values for predicting neurologic outcomes of post-CA patients. Results: 48 patients were included, 24 in the poor outcome group and 24 in the good outcome group. The difference in ONSD between the two groups of patients initially after ROSC was not statistically significant, and the area under the curve (AUC) was 0.665; the differences in ONSD between the two groups at 12 to 24 hours, day 2, and day 3 were statistically significant, and the AUCs were 0.785, 0.837, and 0.841 respectively. Conclusion: Measuring the ONSD by ultrasonography at 12～24 hours, day 2, and day 3 after ROSC in post-CA patients has good value in predicting neurologic prognosis. Measurement of ONSD on day 2 may be the optimal time to evaluate the neurological prognosis of patients after CA.