Do you know the symptoms of post-resuscitation encephalopathy? What are the aftereffects and preventive measures?

 

When the heart starts beating again from a cardiopulmonary arrest, it is never uncommon for a brain disorder to remain and be diagnosed with encephalopathy after resuscitation. "Why won't I wake up?" "Will there be any aftereffects?" I can't fathom the anxiety of my family and people around me. This time, we heard about the symptoms and treatment methods of encephalopathy after resuscitation. Let's find out how to prevent the aftereffects you're curious about.

What is post-resuscitation encephalopathy?

After resuscitation, encephalopathy is a condition in which serious aftereffects remain in the brain when revived from cardiopulmonary arrest. There are various factors that cause cardiopulmonary arrest, but representative of them are myocardial infarction, suffocation, shock symptoms, stroke, and pulmonary infarction. Cardiopulmonary arrest is a state in which the heart and lungs have stopped moving as the name suggests. The heart and lungs are important organs for life. When this movement stops, the blood flow stops and oxygen shared throughout the body along with the blood stops spreading. Even if your heart starts beating again, the effects of the temporary lack of oxygen in your brain are immeasurable.

What causes encephalopathy after resuscitation?

The main cause of encephalopathy after resuscitation is that oxygen supply is interrupted by cardiac arrest. If oxygen is not delivered to the brain, the brain's function is also blocked, causing great damage to the brain and the whole body. It is "resuscitation" for the heart to start beating again from a cardiopulmonary arrest, but the resuscitation rate changes significantly depending on the time the heart stops. Also, even if it is resuscitated, the longer the heart stops, the higher the risk of developing encephalopathy after resuscitation. Also, hypoxia is not the only cause of encephalopathy after resuscitation. In a recent study, encephalopathy after resuscitation is known to increase the risk of ischemic re-perfusion disorder as blood flow resumes. Ischemic re-perfusion is also a toxin that flows when cells necrosis when blood stops flowing and blood starts flowing again (reperfusion). Disorders throughout the body caused by the toxin are called ischemic re-perfusion disorders.

Please let me know the symptoms of encephalopathy after resuscitation.

After resuscitation, if the heart is in critical condition, even if the heart rate resumes, the consciousness does not return, resulting in a "chaotic state." There is no "voluntary breathing" that breathes with one's own power, and even if there is, it is so weak that it cannot sustain life alone. It is not uncommon for encephalopathy after resuscitation to show symptoms such as high blood sugar and high blood pressure due to brain damage. You can't eat because you're unconscious, but you need blood sugar control because the IV contains sugar. Other serious symptoms include paralysis of the hands and feet and convulsions. Cognitive dysfunction can also occur even if consciousness returns after the heart rate resumes, and this is one of the symptoms of encephalopathy after resuscitation. In addition to these symptoms, there are symptoms that determine the prognosis as follows.

• Myochronose epilepsy critical condition (within 24 hours after cardiac resumption)
• Pupil response, corneal reflex loss, motor response loss after 3 days, or limb abnormal extension reaction

It is known that these symptoms make recovery difficult.

After resuscitation, encephalopathy is a life-threatening condition.

Diagnosis and examination of encephalopathy after resuscitation

There are no clear diagnostic criteria for encephalopathy after resuscitation, so it is comprehensively diagnosed with various test results. After resuscitation, most of them are transferred to the hospital in a cardiopulmonary arrest state on the premise of diagnosis of encephalopathy. Therefore, first, necessary tests and treatments are conducted to find out the cause of cardiopulmonary arrest. In some cases, even if the heart rate resumes, you may not wake up, remain conscious within a few days, and the progress after resuscitation varies. Even when consciousness returns, there are many cases where the aftereffects are caused by damage during cardiopulmonary arrest. If a certain brain disorder remains after resuscitation, it is diagnosed as "post-resuscitation encephalopathy." There are many cases where hypoxia is diagnosed, but it doesn't matter if you understand it in the same sense.

Please tell me the details of the test for encephalopathy after resuscitation.

In most cases, blood tests, CT tests, and MRI tests are performed. In coma, brainwave tests are often performed to check brain movement. Since there are no clear diagnostic criteria, these tests or symptoms are comprehensively judged and diagnosed as encephalopathy after resuscitation.

How to treat encephalopathy after resuscitation and prognosis?

The treatment of encephalopathy after resuscitation is mainly systemic management, including respiratory management. There are many cases where blood pressure fluctuates due to lack of spontaneous breathing in a coma with a brain disorder. Therefore, it is equipped with a respirator to assist breathing, and an electrocardiogram or a blood pressure meter is always installed to manage it with a monitor. Advanced medical care is required and treatment is often performed in the ICU. It is known that if you become a coma due to encephalopathy after resuscitation, it is easy to become solid temperature and hypothermia is effective. Hypothermia is a structure that suppresses brain metabolism and reduces the amount of oxygen the brain needs by intentionally lowering body temperature. Although the body temperature is intentionally lowered using sedatives, cold fluids, and whole body cooling methods on the surface, hypothermia is also under careful management at the ICU because full body care is required.

If I have encephalopathy after resuscitation, will there be aftereffects?

The reality is that there are never a few cases of aftereffects if you get encephalopathy after resuscitation. In some cases, they cannot wake up in a coma, so many people lose their lives due to encephalopathy after resuscitation. Even if you wake up, there are people who have cognitive impairment or paralysis of their hands and feet, or who just lie down. However, even if the aftereffects remain, it is not impossible to return to society. Young people are more likely to recover than the elderly, and some people return to society after suffering from encephalopathy after resuscitation.

How long does the treatment take? I'd like to know if it's cured.

The period of treatment for encephalopathy after resuscitation is not uniform, but it is characterized by a large individual difference. Some people wake up after a few days in a coma, and others do not wake up for more than a month. The treatment period varies from person to person because there are parts where it is not possible to determine how much aftereffects remain without awakening. In addition, in critical cases where you do not wake up in a coma, you can make a "legal brain death judgment." This is done when you or your family are willing to transplant, and the possibility of a "donor card" is greatly influenced by your will. What is confirmed by legal brain death is mainly the presence or absence of spontaneous breathing, pupil size, brain-to-brain reflex, and blood pressure. The more we think about the possibility of brain death, the more we can see that post-resuscitation encephalopathy is a life-related critical condition.

Please tell me if there is a way to prevent encephalopathy after resuscitation.

The way to prevent encephalopathy after resuscitation is to not stop supplying oxygen when it is cardiopulmonary arrest. If you find out that you are unconscious, check your heart's movements. It can be confirmed by touching the heart or touching the ears to the chest. And if your heart stops, immediately apply sternal compression (heart massage). It is known that more than 100 chest compressions per minute are effective, which can continuously provide oxygen to the brain. If there is an AED (automatic in vitro defibrillator) nearby, using it leads to the prevention of encephalopathy after resuscitation in the case of acute myocardial infarction or cardiopulmonary arrest due to psychogenic shock.

It is also important to call an ambulance immediately. If there are several people in the position, it will be smooth if you respond by dividing it into a person who compresses the sternum and a person who calls an ambulance. It is known that it is good to perform artificial respiration twice per 30 chest compressions, but it will also be repulsed to perform artificial respiration directly with your mouth.

In this case, it is known that there is no problem if artificial respiration is omitted. Chest compression and AED are most important so that the heart does not stop moving.

When the cardiopulmonary arrest occurs, resuscitation is the first priority. However, even if the magnetic heart rate resumes, it is not uncommon to not recover from a coma or just lie down. Even so, if you can cope with cardiopulmonary arrest right away, there is a possibility of recovery without leaving any aftereffects. It is known that if the heart stops, the survival rate drops by 7-10% every minute, and if you find someone who is in cardiopulmonary arrest, it is important to not hesitate to start chest compression.

Also, let's call an ambulance quickly and take it to the hospital. Minimizing the time the heart stops affects the risk or prognosis of post resuscitation encephalopathy. Post-resuscitation encephalopathy is a state of brain damage that occurs after cardiopulmonary arrest and resuscitation. In general, even if the heart rate of patients who have fallen into cardiopulmonary arrest outside the hospital resumes, about 70% of them will be killed by encephalopathy after this resuscitation. In addition, even if it does not, there are many cases where the brain remains in a state of lying down. Therefore, preventing encephalopathy after resuscitation is a very important point.

arrangement

After resuscitation, encephalopathy is a brain disorder caused by cardiopulmonary arrest. When cardiopulmonary arrest occurs, blood or oxygen does not spread evenly throughout the body, including the brain, so even if the heart rate resumes, damage to the brain increases. If you have encephalopathy after resuscitation, you are at high risk of leaving aftereffects, and you may not be awakened in a coma. Since the time when the heart is stopped affects encephalopathy or prognosis after resuscitation, if there is anyone who has a cardiac arrest, don't hesitate to act.