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Neuro prognosis after arrest 1

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6 papers 0 to 25 followers
By Jason Mann No BS pulmonary critical care fellow
Claudio Sandroni, Romergryko G Geocadin
PURPOSE OF REVIEW: Prediction of neurological prognosis in patients who are comatose after successful resuscitation from cardiac arrest remains difficult. Previous guidelines recommended ocular reflexes, somatosensory evoked potentials and serum biomarkers for predicting poor outcome within 72  h from cardiac arrest. However, these guidelines were based on patients not treated with targeted temperature management and did not appropriately address important biases in literature. RECENT FINDINGS: Recent evidence reviews detected important limitations in prognostication studies, such as low precision and, most importantly, lack of blinding, which may have caused a self-fulfilling prophecy and overestimated the specificity of index tests...
June 2015: Current Opinion in Critical Care
Claudio Sandroni, Alain Cariou, Fabio Cavallaro, Tobias Cronberg, Hans Friberg, Cornelia Hoedemaekers, Janneke Horn, Jerry P Nolan, Andrea O Rossetti, Jasmeet Soar
OBJECTIVES: To review and update the evidence on predictors of poor outcome (death, persistent vegetative state or severe neurological disability) in adult comatose survivors of cardiac arrest, either treated or not treated with controlled temperature, to identify knowledge gaps and to suggest a reliable prognostication strategy. METHODS: GRADE-based systematic review followed by expert consensus achieved using Web-based Delphi methodology, conference calls and face-to-face meetings...
December 2014: Intensive Care Medicine
Claudio Sandroni, Fabio Cavallaro, Clifton W Callaway, Tommaso Sanna, Sonia D'Arrigo, Michael Kuiper, Giacomo Della Marca, Jerry P Nolan
AIMS AND METHODS: To systematically review the accuracy of early (≤7 days) predictors of poor outcome defined as death or vegetative state (Cerebral Performance Categories [CPC] 4-5) or death, vegetative state or severe disability (CPC 3-5) in comatose survivors from cardiac arrest not treated using therapeutic hypothermia (TH). PubMed, Scopus and the Cochrane Database of Systematic reviews were searched for eligible studies. Sensitivity, specificity, false positive rates (FPR) for each predictor were calculated and results of predictors with similar time points and outcome definitions were pooled...
October 2013: Resuscitation
David B Seder, Kjetil Sunde, Sten Rubertsson, Michael Mooney, Pascal Stammet, Richard R Riker, Karl B Kern, Barbara Unger, Tobias Cronberg, John Dziodzio, Niklas Nielsen
OBJECTIVES: To evaluate the outcomes of cardiac arrest survivors with myoclonus receiving modern postresuscitation care. DESIGN: Retrospective review of registry data. SETTING: Cardiac arrest receiving centers in Europe and the United States from 2002 to 2012. PATIENTS: Two thousand five hundred thirty-two cardiac arrest survivors 18 years or older enrolled in the International Cardiac Arrest Registry. INTERVENTIONS: None...
May 2015: Critical Care Medicine
Mauro Oddo, Andrea O Rossetti
OBJECTIVES: Therapeutic hypothermia and pharmacological sedation may influence outcome prediction after cardiac arrest. The use of a multimodal approach, including clinical examination, electroencephalography, somatosensory-evoked potentials, and serum neuron-specific enolase, is recommended; however, no study examined the comparative performance of these predictors or addressed their optimal combination. DESIGN: Prospective cohort study. SETTING: Adult ICU of an academic hospital...
June 2014: Critical Care Medicine
Marleen C Tjepkema-Cloostermans, Fokke B van Meulen, Gjerrit Meinsma, Michel J A M van Putten
INTRODUCTION: Electroencephalogram (EEG) monitoring in patients treated with therapeutic hypothermia after cardiac arrest may assist in early outcome prediction. Quantitative EEG (qEEG) analysis can reduce the time needed to review long-term EEG and makes the analysis more objective. In this study, we evaluated the predictive value of qEEG analysis for neurologic outcome in postanoxic patients. METHODS: In total, 109 patients admitted to the ICU for therapeutic hypothermia after cardiac arrest were included, divided over a training and a test set...
2013: Critical Care: the Official Journal of the Critical Care Forum
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