PREDICTORS OF POOR NEUROLOGIC OUTCOME AFTER INDUCED MILD HYPOTHERMIA FOLLOWING CARDIAC ARREST
| Autor: | W. D. Freeman, K. M. Barrett, M. L. Biewend, M. M. Johnson, G. D. Divertie, J. F. Meschia, G. Bryan Young FAAN |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Resuscitation
medicine.medical_treatment Unconsciousness Status epilepticus Reflex Pupillary Hypothermia Induced Predictive Value of Tests Outcome Assessment Health Care Humans Medicine Corneal reflex Cardiopulmonary resuscitation Physical Examination Retrospective Studies Neurologic Examination Dyskinesias Reflex Abnormal business.industry Persistent Vegetative State Retrospective cohort study Recovery of Function Hypothermia Prognosis Heart Arrest Survival Rate Predictive value of tests Anesthesia Hypoxia-Ischemia Brain Neurology (clinical) medicine.symptom business Myoclonus Biomarkers |
| Zdroj: | Neurology. 73:997-998 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0b013e3181af0c42 |
| Popis: | Background: Several predictors of poor neurologic outcome after cardiac arrest (CA) were proven to be valid. However, these studies preceded the advent of therapeutic induced mild hypothermia (TIMH), which may alter their validity. The objective of this study is to reassess the validity of these predictors in post-CA patients treated with TIMH. Methods: Retrospective chart review of 37 consecutive adults who were comatose after resuscitation from CA and treated with TIMH. Results: None of six patients without pupillary reactivity, six without corneal reflexes on day 3, or eight with myoclonus status epilepticus recovered awareness. Two of 14 patients with motor responses no better than extension at day 3 recovered motor responses only after 6 days post-arrest (one at 5 and one at 6 days post-rewarming) and regained awareness. Conclusions: Loss of motor responses better than extension on day 3 was not prognostically reliable after therapeutic induced mild hypothermia for comatose cardiac arrest survivors. None of the patients who lost pupillary or corneal reflexes on day 3 or developed myoclonus status epilepticus recovered awareness. |
| Databáze: | OpenAIRE |
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