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2015 | OriginalPaper | Buchkapitel

31. Hypoxisch-ischämische Enzephalopathie

verfasst von : Wolfgang Müllges, Prof. Dr., Thorsten M. Odorfer, Dr.

Erschienen in: NeuroIntensiv

Verlag: Springer Berlin Heidelberg

Zusammenfassung

Das Kapitel behandelt ausschließlich denjenigen Schweregrad einer hypoxisch-ischämischen Enzephalopathie (HIE), der einen Patienten auf die Intensivstation führt. Es handelt sich stets um eine generalisierte Hirnschädigung, deren Ausmaß und Topographie vom Schweregrad einer vorausgegangenen transienten globalen Hypoxie und/oder globalen Ischämie abhängen. Für asphyktische Neugeborene und für Kinder gelten andere Verhältnisse, die hier nicht erläutert werden.
Literatur
1.
2.
Zurück zum Zitat Arpino PA, Greer DM (2008) Practical pharmacological aspects of therapeutic hypothermia after cardiac arrest. Pharmacotherapy 28:102–108CrossRefPubMed Arpino PA, Greer DM (2008) Practical pharmacological aspects of therapeutic hypothermia after cardiac arrest. Pharmacotherapy 28:102–108CrossRefPubMed
3.
Zurück zum Zitat Bernard SA, Gray TW, Buist MD et al (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. New Engl J Med 346:557–563CrossRefPubMed Bernard SA, Gray TW, Buist MD et al (2002) Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. New Engl J Med 346:557–563CrossRefPubMed
5.
Zurück zum Zitat Cronberg T, Lilja G, Rundgren M, Friberg H, Widner H (2009) Long-term neurological outcome after cardiac arrest and therapeutic hypothermia. Resuscitation 80:1119–1123CrossRefPubMed Cronberg T, Lilja G, Rundgren M, Friberg H, Widner H (2009) Long-term neurological outcome after cardiac arrest and therapeutic hypothermia. Resuscitation 80:1119–1123CrossRefPubMed
6.
Zurück zum Zitat Cronberg T, Brizzi M, Liedholm LJ et al (2013) Neurological prognostication after cardiac arrest – recommendations from the swedish resuscitation Council. Resuscitation 84:867–872CrossRefPubMed Cronberg T, Brizzi M, Liedholm LJ et al (2013) Neurological prognostication after cardiac arrest – recommendations from the swedish resuscitation Council. Resuscitation 84:867–872CrossRefPubMed
7.
Zurück zum Zitat Dirnagl U, Iadecola C, Moskowitz MA (1999) Pathobiology of ischemic stroke: an integrated view. Trends Neurosci 22:391–397CrossRefPubMed Dirnagl U, Iadecola C, Moskowitz MA (1999) Pathobiology of ischemic stroke: an integrated view. Trends Neurosci 22:391–397CrossRefPubMed
8.
Zurück zum Zitat Dumas F, Grimaldi D, Zuber B et al (2011) Is hypothermia after cardiac arrest effective in both shockable ans nonshockable patients? Circulation 123:877–886CrossRefPubMed Dumas F, Grimaldi D, Zuber B et al (2011) Is hypothermia after cardiac arrest effective in both shockable ans nonshockable patients? Circulation 123:877–886CrossRefPubMed
9.
Zurück zum Zitat Dumas F, White L, Stubbs BA, Caroiu A, Rea TD (2012) Long-term prognosis following resuscitation from out-of-hospital cardiac arrest. J Am Coll Cardiol 60:21–27CrossRefPubMed Dumas F, White L, Stubbs BA, Caroiu A, Rea TD (2012) Long-term prognosis following resuscitation from out-of-hospital cardiac arrest. J Am Coll Cardiol 60:21–27CrossRefPubMed
10.
Zurück zum Zitat Fischer C, Luaute J, Nemoz C et al (2006) Improved prediction of awakening or nonawakening from severe anoxic coma using tree-based classification analysis. Crit Care Med 34:1520–1524CrossRefPubMed Fischer C, Luaute J, Nemoz C et al (2006) Improved prediction of awakening or nonawakening from severe anoxic coma using tree-based classification analysis. Crit Care Med 34:1520–1524CrossRefPubMed
11.
Zurück zum Zitat Geurts M, MacLeod MR, Kollmar R, Kremer PH, van der Worp HB (2014) Therapeutic hypothermia and the risk of infection: a systematic review and meta-analysis. Crit Care Med 42:231–242CrossRefPubMed Geurts M, MacLeod MR, Kollmar R, Kremer PH, van der Worp HB (2014) Therapeutic hypothermia and the risk of infection: a systematic review and meta-analysis. Crit Care Med 42:231–242CrossRefPubMed
12.
Zurück zum Zitat Gold B, Puertas L, Davis SP et al (2014) Awakening after cardiac arrest and post resuscitation hypothermia: are we pulling the plug too early? Resuscitation 85:211–214CrossRefPubMed Gold B, Puertas L, Davis SP et al (2014) Awakening after cardiac arrest and post resuscitation hypothermia: are we pulling the plug too early? Resuscitation 85:211–214CrossRefPubMed
13.
Zurück zum Zitat Greer DM, Yang J, Scripko P et al (2012) Clinical examination for outcome prediction in nontraumatic coma. Crit Care Med 40:1150–1156CrossRefPubMed Greer DM, Yang J, Scripko P et al (2012) Clinical examination for outcome prediction in nontraumatic coma. Crit Care Med 40:1150–1156CrossRefPubMed
14.
Zurück zum Zitat Greer DM, Rosenthal ES, Wu O (2014) Neuroprognostication of hypoxic-ischaemic coma in the therapeutic hypothermia era. Nat Rev Neurol 10:190–203CrossRefPubMed Greer DM, Rosenthal ES, Wu O (2014) Neuroprognostication of hypoxic-ischaemic coma in the therapeutic hypothermia era. Nat Rev Neurol 10:190–203CrossRefPubMed
15.
Zurück zum Zitat Hessel EA 2nd (2014) Therapeutic hypothermia after in-hospital cardiac arrest: a critique. J Cardiothorac Vasc Anesth 28:789–799CrossRefPubMed Hessel EA 2nd (2014) Therapeutic hypothermia after in-hospital cardiac arrest: a critique. J Cardiothorac Vasc Anesth 28:789–799CrossRefPubMed
16.
Zurück zum Zitat Holzer M, Bernard SA, Hachimi-Idrissi S et al (2005) Hypothermia for neuroprotection after cardiac arrest. Crit Care Med 33:414–418CrossRefPubMed Holzer M, Bernard SA, Hachimi-Idrissi S et al (2005) Hypothermia for neuroprotection after cardiac arrest. Crit Care Med 33:414–418CrossRefPubMed
17.
Zurück zum Zitat Hunter BR, O´Donnell DP, Allgood KL, Segpaul RA (2014) No benefit of prehospital initiation of therapeutic hypothermia in out-of-hospital cardiac arrest. Acad Emerg Med 21:355–364CrossRefPubMed Hunter BR, O´Donnell DP, Allgood KL, Segpaul RA (2014) No benefit of prehospital initiation of therapeutic hypothermia in out-of-hospital cardiac arrest. Acad Emerg Med 21:355–364CrossRefPubMed
18.
Zurück zum Zitat Kamps MJ, Horn J, Oddo M et al (2013) Prognostication of neurologic outcome in cardiac arrest patients after mild therapeutic hypothermia. Intensive Care Med 39:1671–1682CrossRefPubMed Kamps MJ, Horn J, Oddo M et al (2013) Prognostication of neurologic outcome in cardiac arrest patients after mild therapeutic hypothermia. Intensive Care Med 39:1671–1682CrossRefPubMed
19.
Zurück zum Zitat Kim F, Nichol G, Maynard C et al (2014) Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA 311:45–52CrossRefPubMed Kim F, Nichol G, Maynard C et al (2014) Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA 311:45–52CrossRefPubMed
20.
Zurück zum Zitat Kim WY, Giberson TA, Uber A, Berg K, Cocchi MN, Donnino MW (2014) Neurologic aoutcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia. Resuscitation 85:1042–1046CrossRefPubMedPubMedCentral Kim WY, Giberson TA, Uber A, Berg K, Cocchi MN, Donnino MW (2014) Neurologic aoutcome in comatose patients resuscitated from out-of-hospital cardiac arrest with prolonged downtime and treated with therapeutic hypothermia. Resuscitation 85:1042–1046CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Lee YC, Phan TG, Jolley DJ et al (2010) Accuracy of clinical signs, SEP, and EEG in predicting outcome of hypoxic coma. A metaanalysis. Neurology 74:572–580CrossRefPubMed Lee YC, Phan TG, Jolley DJ et al (2010) Accuracy of clinical signs, SEP, and EEG in predicting outcome of hypoxic coma. A metaanalysis. Neurology 74:572–580CrossRefPubMed
22.
Zurück zum Zitat Lee BK, Lee SJ, Jeung KW, Lee HY, Heo T, Min YI (2014) Outcome and adverse events with 72-hour cooling at 32oC as compared to 24-hour cooling at 33oC in comatose asphyxia arrest survivors. Am J Emerg Med 32:297–301CrossRefPubMed Lee BK, Lee SJ, Jeung KW, Lee HY, Heo T, Min YI (2014) Outcome and adverse events with 72-hour cooling at 32oC as compared to 24-hour cooling at 33oC in comatose asphyxia arrest survivors. Am J Emerg Med 32:297–301CrossRefPubMed
23.
Zurück zum Zitat Leithner C, Ploner C, Hasper D, Storm C (2010) Does hypothermia influence the predictive value of bilateral absent N20 after cardiac arrest? Neurology 74:965–969CrossRefPubMed Leithner C, Ploner C, Hasper D, Storm C (2010) Does hypothermia influence the predictive value of bilateral absent N20 after cardiac arrest? Neurology 74:965–969CrossRefPubMed
24.
Zurück zum Zitat Levy DE, Caronna JJ, Singer BH et al (1985) Predicting outcome from hypoxic-ischemic coma. JAMA 253:1420–1426CrossRefPubMed Levy DE, Caronna JJ, Singer BH et al (1985) Predicting outcome from hypoxic-ischemic coma. JAMA 253:1420–1426CrossRefPubMed
25.
Zurück zum Zitat Loma-Osorio P, Aboal J, Sanz M et al (2013) Caracteristicas clinicas, pronostico vital y functional de los pacientes supervivientes a una muerte subita extrahospitalaria ingresados en cinco iunidades de cuidados intensivos cardiologicos. Rev Esp Cardiol 66:623–628CrossRefPubMed Loma-Osorio P, Aboal J, Sanz M et al (2013) Caracteristicas clinicas, pronostico vital y functional de los pacientes supervivientes a una muerte subita extrahospitalaria ingresados en cinco iunidades de cuidados intensivos cardiologicos. Rev Esp Cardiol 66:623–628CrossRefPubMed
26.
Zurück zum Zitat Longstreth WT, Diehr P, Inui TS (1983) Prediction of awakening after out-of-hospital cardiac arrest. N Engl J Med 308:1378–1382CrossRefPubMed Longstreth WT, Diehr P, Inui TS (1983) Prediction of awakening after out-of-hospital cardiac arrest. N Engl J Med 308:1378–1382CrossRefPubMed
27.
Zurück zum Zitat Lundbye JB, Rai M, Ramu B et al (2012) Therapeutic hypothermia is associated with improved neurologic outcome and survival in cardiac arrest survivors of nin-shockable rythms. Resuscitation 83:202–207CrossRefPubMed Lundbye JB, Rai M, Ramu B et al (2012) Therapeutic hypothermia is associated with improved neurologic outcome and survival in cardiac arrest survivors of nin-shockable rythms. Resuscitation 83:202–207CrossRefPubMed
28.
Zurück zum Zitat Madl C, Kramer L, Donnavits H et al (2000) Improved outcome prediction in unconscious cardiac arrest survivors with sensory evoked potentials compared with clinical assessment. Crit Care Med 28:721–726CrossRefPubMed Madl C, Kramer L, Donnavits H et al (2000) Improved outcome prediction in unconscious cardiac arrest survivors with sensory evoked potentials compared with clinical assessment. Crit Care Med 28:721–726CrossRefPubMed
29.
Zurück zum Zitat Mörtberg E, Zetterberg H, Nordmark J, Blennow K, Rosengren L, Rubertson S (2011) S100B is superior to NSE, BDNF and GFAP in predicting outcome of resuscitation from cardiac arrest with hypothermia treatment. Resuscitation 82:26–31CrossRefPubMed Mörtberg E, Zetterberg H, Nordmark J, Blennow K, Rosengren L, Rubertson S (2011) S100B is superior to NSE, BDNF and GFAP in predicting outcome of resuscitation from cardiac arrest with hypothermia treatment. Resuscitation 82:26–31CrossRefPubMed
30.
Zurück zum Zitat Müllges W, Stoll G (2002) Hypoxisch-ischämische Encephalopathie. Akt Neurol 29:431–447CrossRef Müllges W, Stoll G (2002) Hypoxisch-ischämische Encephalopathie. Akt Neurol 29:431–447CrossRef
31.
Zurück zum Zitat Nair SU, Lundbye JB (2013) The occurrence of shivering in cardiac arrest survivors undergoing therapeutic hypothermia is associated with a good neurologic outcome. Resuscitation 84:626–629CrossRefPubMed Nair SU, Lundbye JB (2013) The occurrence of shivering in cardiac arrest survivors undergoing therapeutic hypothermia is associated with a good neurologic outcome. Resuscitation 84:626–629CrossRefPubMed
32.
Zurück zum Zitat Neumar RW, Nolan JP, Adrie C et al (2008) Postcardiac arrest syndrome. ILCOR Consensus Statement. Circulation 118:2452–2483CrossRefPubMed Neumar RW, Nolan JP, Adrie C et al (2008) Postcardiac arrest syndrome. ILCOR Consensus Statement. Circulation 118:2452–2483CrossRefPubMed
33.
Zurück zum Zitat Nielsen N et al (2013) Targeted temperature management at 33oC versus 36oC after cardiac arrest. N Engl J Med 369:2197–2206CrossRefPubMed Nielsen N et al (2013) Targeted temperature management at 33oC versus 36oC after cardiac arrest. N Engl J Med 369:2197–2206CrossRefPubMed
34.
Zurück zum Zitat Noyes AM, Lundbye JB (2013) Managing the complications of mild therapeutic hypothermia in the cardiac arrest patient. J Intensive Care Med (epub Dec 25) Noyes AM, Lundbye JB (2013) Managing the complications of mild therapeutic hypothermia in the cardiac arrest patient. J Intensive Care Med (epub Dec 25)
35.
Zurück zum Zitat Pleskot M, Hazukova R, Stritecka H, Cermakova E, Pudil R (2009) Long-term prognosis after out-of-hospital cardiac arrest with/without ST elevation myocardial infarction. Resuscitation 80:795–804CrossRefPubMed Pleskot M, Hazukova R, Stritecka H, Cermakova E, Pudil R (2009) Long-term prognosis after out-of-hospital cardiac arrest with/without ST elevation myocardial infarction. Resuscitation 80:795–804CrossRefPubMed
36.
Zurück zum Zitat Rech TH, Viera SR, Nagel F et al (2006) Serum neuron-specific enolase as early predictor of outcome after in-hospital cardiac arrest. Crit Care 10:R133CrossRefPubMedPubMedCentral Rech TH, Viera SR, Nagel F et al (2006) Serum neuron-specific enolase as early predictor of outcome after in-hospital cardiac arrest. Crit Care 10:R133CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Rossetti AO, Oddo M, Logroscino G, Kaplan PW (2010) Prognostication after cardiac arrest and hypothermia. Ann Neurol 67:301–307PubMed Rossetti AO, Oddo M, Logroscino G, Kaplan PW (2010) Prognostication after cardiac arrest and hypothermia. Ann Neurol 67:301–307PubMed
38.
Zurück zum Zitat Rundgren M, Westhall E, Cronberg T, Rosen I, Friberg H (2010) Continuous amplitude-integrated electroencephalogram predicts outcome in hypothermia-treated cardiac arrest patients. Crit Care Med 38:1838–1844CrossRefPubMed Rundgren M, Westhall E, Cronberg T, Rosen I, Friberg H (2010) Continuous amplitude-integrated electroencephalogram predicts outcome in hypothermia-treated cardiac arrest patients. Crit Care Med 38:1838–1844CrossRefPubMed
39.
Zurück zum Zitat Sandroni C, Cavallaro RF, Calaway CW et al (2013) Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest. Resuscitation 84:1324–1338CrossRefPubMed Sandroni C, Cavallaro RF, Calaway CW et al (2013) Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest. Resuscitation 84:1324–1338CrossRefPubMed
40.
Zurück zum Zitat Shinozaki K, Oda S, Sadahir T et al (2012) Duration of well-controlled core temperature correlates with neurological outcome in patuients with post-cardiac arrest syndrome. Am J Emerg Med 30:1838–1844CrossRefPubMed Shinozaki K, Oda S, Sadahir T et al (2012) Duration of well-controlled core temperature correlates with neurological outcome in patuients with post-cardiac arrest syndrome. Am J Emerg Med 30:1838–1844CrossRefPubMed
41.
Zurück zum Zitat Soleimanpour H, Rahmani F, Golzari SE, Safari S (2014) Main complications of mild induced hypothermia after cardiac arrest: a review article. J Cardiovasc Thorac Res 6:1–8PubMedPubMedCentral Soleimanpour H, Rahmani F, Golzari SE, Safari S (2014) Main complications of mild induced hypothermia after cardiac arrest: a review article. J Cardiovasc Thorac Res 6:1–8PubMedPubMedCentral
42.
Zurück zum Zitat Steffen IG, Hasper D, Ploner C, Schefold JC, Dietz E et al (2010) Mild therapeutic hypothermia alters neuron specific enolase as an outcome predictor after resuscitation. Crit Care 14:R69CrossRefPubMedPubMedCentral Steffen IG, Hasper D, Ploner C, Schefold JC, Dietz E et al (2010) Mild therapeutic hypothermia alters neuron specific enolase as an outcome predictor after resuscitation. Crit Care 14:R69CrossRefPubMedPubMedCentral
43.
Zurück zum Zitat Steinmetz J, Barning S, Nielsen SL et al (2008) Improved survival after out-of-hospital cardiac arrest using new guidelines. Acta Anaesthesiol Scand 52:908–913CrossRefPubMed Steinmetz J, Barning S, Nielsen SL et al (2008) Improved survival after out-of-hospital cardiac arrest using new guidelines. Acta Anaesthesiol Scand 52:908–913CrossRefPubMed
44.
Zurück zum Zitat The Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. New Engl J Med 346:549–556CrossRef The Hypothermia after Cardiac Arrest Study Group (2002) Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. New Engl J Med 346:549–556CrossRef
45.
Zurück zum Zitat The Multi-Society Task Force on (1994) Medical aspects of the persistent vegetative state. N Engl J Med 330:1499–1508 (1572–1579)CrossRef The Multi-Society Task Force on (1994) Medical aspects of the persistent vegetative state. N Engl J Med 330:1499–1508 (1572–1579)CrossRef
46.
Zurück zum Zitat Tzovara A (2013) Progression of auditory discrimination based on neural decoding predicts awakening from coma. Brain 136:81–89CrossRefPubMed Tzovara A (2013) Progression of auditory discrimination based on neural decoding predicts awakening from coma. Brain 136:81–89CrossRefPubMed
47.
Zurück zum Zitat van der Wal G, Brinkman S, Bisschops LLA et al (2011) Influence of mild therapeutic hypothermia after cardiac arrest on hospital mortality. Crit Care Med 39:84–88CrossRefPubMed van der Wal G, Brinkman S, Bisschops LLA et al (2011) Influence of mild therapeutic hypothermia after cardiac arrest on hospital mortality. Crit Care Med 39:84–88CrossRefPubMed
49.
Zurück zum Zitat Wijdicks EF, Hijdra A, Young GB et al (2006) Practice parameter: prediction of outcome of comatose survivors after cardiopulmonary resuscitation. Neurology 67:203–210CrossRefPubMed Wijdicks EF, Hijdra A, Young GB et al (2006) Practice parameter: prediction of outcome of comatose survivors after cardiopulmonary resuscitation. Neurology 67:203–210CrossRefPubMed
50.
Zurück zum Zitat Zandbergen EGJ, de Haan RJ, Stoutenbeck CP et al (1998) Systematic review of early prediction of poor outcome in anoxic-ischaemic coma. Lancet 352:1808–1812CrossRefPubMed Zandbergen EGJ, de Haan RJ, Stoutenbeck CP et al (1998) Systematic review of early prediction of poor outcome in anoxic-ischaemic coma. Lancet 352:1808–1812CrossRefPubMed
51.
Zurück zum Zitat Zandbergen EGJ, Hijdra A, Koelman JHTM et al (2006) Prediction of poor outcome within the first three days of postanoxic coma. Neurology 66:62–68CrossRefPubMed Zandbergen EGJ, Hijdra A, Koelman JHTM et al (2006) Prediction of poor outcome within the first three days of postanoxic coma. Neurology 66:62–68CrossRefPubMed
52.
Zurück zum Zitat Zandbergen EGJ, Koelman JHTM, deHaan RJ et al (2006) SSEPs and prognosis in postanoxic coma. Neurology 67:583–586CrossRefPubMed Zandbergen EGJ, Koelman JHTM, deHaan RJ et al (2006) SSEPs and prognosis in postanoxic coma. Neurology 67:583–586CrossRefPubMed
Metadaten
Titel
Hypoxisch-ischämische Enzephalopathie
verfasst von
Wolfgang Müllges, Prof. Dr.
Thorsten M. Odorfer, Dr.
Copyright-Jahr
2015
Verlag
Springer Berlin Heidelberg
DOI
https://doi.org/10.1007/978-3-662-46500-4_31

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