| Prediction of poor outcome within the first 3 days of postanoxic coma. | |
| | |
MedLine Citation:
|
PMID: 16401847 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To determine the optimal timing of somatosensory evoked potential (SSEP) recordings and the additional value of clinical and biochemical variables for the prediction of poor outcome in patients who remain comatose after cardiopulmonary resuscitation (CPR). METHODS: A prospective cohort study was conducted in 32 intensive care units including adult patients still unconscious 24 hours after CPR. Clinical, neurophysiologic, and biochemical variables were recorded 24, 48, and 72 hours after CPR and related to death or persisting unconsciousness after 1 month. RESULTS: Of 407 included patients, 356 (87%) had a poor outcome. In 301 of 305 patients unconscious at 72 hours, at least one SSEP was recorded, and in 136 (45%), at least one recording showed bilateral absence of N20. All these patients had a poor outcome (95% CI of false positive rate 0 to 3%), irrespective of the timing of SSEP. In the same 305 patients, neuron-specific enolase (NSE) was determined at least once in 231, and all 138 (60%) with a value >33 microg/L at any time had a poor outcome (95% CI of false positive rate 0 to 3%). The test results of SSEP and NSE overlapped only partially. The performance of all clinical tests was inferior to SSEP and NSE testing, with lower prevalences of abnormal test results and wider 95% CI of false positive rates. CONCLUSION: Poor outcome in postanoxic coma can be reliably predicted with somatosensory evoked potentials and neuron-specific enolase as early as 24 hours after cardiopulmonary resuscitation in a substantial number of patients. |
| | |
Authors:
|
E G J Zandbergen; A Hijdra; J H T M Koelman; A A M Hart; P E Vos; M M Verbeek; R J de Haan; |
Related Documents
:
|
16814687 - Intensity dependence of auditory-evoked cortical potentials in fibromyalgia patients: a... 22733017 - Amyloidosis of the gastrointestinal tract: a 13-year single center referral experience. 7324937 - Neuronal ceroidlipofuscinosis: cct findings in fourteen patients. 21683267 - Contribution of laboratory methods in diagnosing clinically suspected ocular toxoplasmo... 7816257 - Interleukin-8 in chronic renal failure and dialysis patients. 7074807 - Identification of transient and persistent segmental wall motion abnormalities in patie... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Neurology Volume: 66 ISSN: 1526-632X ISO Abbreviation: Neurology Publication Date: 2006 Jan |
Date Detail:
|
Created Date: 2006-01-10 Completed Date: 2006-04-20 Revised Date: 2006-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 0401060 Medline TA: Neurology Country: United States |
Other Details:
|
Languages: eng Pagination: 62-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Neurology and Clinical Neurophysiology, Academic Medical Centre, University of Amsterdam, Nijmegen, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Afferent Pathways / pathology, physiopathology* Brain / metabolism, pathology, physiopathology* Cohort Studies Coma / blood, diagnosis*, physiopathology Electroencephalography Evoked Potentials, Somatosensory / physiology* Female Humans Hypoxia, Brain / blood, diagnosis*, physiopathology* Male Neurons / metabolism, pathology Persistent Vegetative State / diagnosis, etiology, physiopathology Phosphopyruvate Hydratase / blood Predictive Value of Tests Prognosis Prospective Studies Time Factors |
| Chemical | |
Reg. No./Substance:
|
EC 4.2.1.11/Phosphopyruvate Hydratase |
| Comments/Corrections | |
Erratum In:
|
Neurology. 2006 Apr 11;66(7):1133 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Deafferentation-disconnection neglect induced by posterior cerebral artery infarction.
Next Document: Population-based case-control study of cognitive function in essential tremor.