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EnglishNeurological prognostication in comatose survivors of cardiac arrest requires a multimodal approach combining clinical and diagnostic tests. Most patients with good outcomes recover consciousness within 72–120 h of arrest, and therefore the suggested timing for prognostication is 72 h from ROSC, or later. Results of earlier prognostic tests, such as status myoclonus and NSE levels, should also be considered at this time point. A careful clinical neurological examination is the cornerstone of prognostic assessment [and it should be performed after major confounders, (e.g. residual sedation,neuromuscular blockade, metabolic derangements) have been excluded.Although absent or extensormotor responses to pain are not specific for predicting a poor neurological outcome, they are highly sensitive for identifying those patients who require neurological prognostication.
| Autori: | |
| Titolo: | Does this comatose survivor of cardiac arrest have a poor prognosis? |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1007/s00134-015-4082-9 |
| Data di pubblicazione: | 2016 |
| Abstract: | Neurological prognostication in comatose survivors of cardiac arrest requires a multimodal approach combining clinical and diagnostic tests. Most patients with good outcomes recover consciousness within 72–120 h of arrest, and therefore the suggested timing for prognostication is 72 h from ROSC, or later. Results of earlier prognostic tests, such as status myoclonus and NSE levels, should also be considered at this time point. A careful clinical neurological examination is the cornerstone of prognostic assessment [and it should be performed after major confounders, (e.g. residual sedation,neuromuscular blockade, metabolic derangements) have been excluded.Although absent or extensormotor responses to pain are not specific for predicting a poor neurological outcome, they are highly sensitive for identifying those patients who require neurological prognostication. |
| Lingua: | Inglese |
| Rivista: | |
| Citazione: | Sandroni, C., Soar, J., Friberg, H., Does this comatose survivor of cardiac arrest have a poor prognosis?, <<INTENSIVE CARE MEDICINE>>, 2016; 42 (1): 104-106. [doi:10.1007/s00134-015-4082-9] [http://hdl.handle.net/10807/72055] |
| Appare nelle tipologie: | Articolo in rivista, Nota a sentenza |
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