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Pain-Related Middle-Latency Somatosensory Evoked Potentials In The Prognosis Of Post Anoxic Coma: A Preliminary Report.
MedLine Citation:
PMID:  22337155     Owner:  NLM     Status:  Publisher    
BACKGROUND: Regarding hypoxic-ischemic encephalopathy, while the bilateral absence of N20/P25 somatosensory evoked potentials (SEPs) is considered to be the best indicator of adverse outcomes, the presence of middle latency evoked potentials (MLCEP) is associated with a favourable neurological prognosis. The main aim of the present study was to investigate whether painful electrical stimulation might be considered a provocative test in producing MLCEP and predictor of patient outcomes after cardiac arrest. METHODS: Retrospective pilot study. SEPs with and without pain-related electrical stimulation in both median nerves were recorded in 17 patients with post anoxic coma after cardiac arrest. Glasgow Coma Scale, electroencephalograms, heart rate and blood pressure changes were also recorded in the same time. Three month after cardiac arrest the same measures with inclusion of Glasgow Outcome Scale Extended was also performed only in the remaining patients with severe neurological outcome. No one intervention was made. RESULTS: Patients who showed MLCEP had a good outcome, while patients without N20/P25 SEPs but with an increase in blood pressure remained in a vegetative state. Patients who did not show N20/P25 SEPs and an increase in blood pressure died within one week. Only one patient who showed N20/P25 SEPs was minimally conscious. CONCLUSION: These preliminary data suggest that MLCEP during painful electrical stimulation seem to be a sensitive method to predict the neurological outcome of patients in the acute phase of coma. Blood pressure response might be a prognostic physiological measure of survival in the vegetative state in patients without N20/P25 SEPs.
P Zanatta; S Messerotti Benvenuti; F Baldanzi; E Bosco
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-15
Journal Detail:
Title:  Minerva anestesiologica     Volume:  -     ISSN:  1827-1596     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375272     Medline TA:  Minerva Anestesiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Cardiac Anesthesia, Neurophysiology, Anesthesia and Intensive Care Department, Treviso Regional Hospital, Treviso, Italy. -
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