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Prediction of good ...
Prediction of good neurological outcome in comatose survivors of cardiac arrest : a systematic review
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- Sandroni, Claudio (author)
- Catholic University of the Sacred Heart, Rome,Policlinico Universitario Agostino Gemelli
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- D’Arrigo, Sonia (author)
- Policlinico Universitario Agostino Gemelli
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- Cacciola, Sofia (author)
- Policlinico Universitario Agostino Gemelli
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- Hoedemaekers, Cornelia W.E. (author)
- Radboud University Medical Center
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- Westhall, Erik (author)
- Lund University,Lunds universitet,Klinisk neurofysiologi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Clinical Neurophysiology,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
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- Kamps, Marlijn J.A. (author)
- Catharina Hospital
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- Taccone, Fabio S. (author)
- Université Libre de Bruxelles (ULB)
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Poole, Daniele (author)
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- Meijer, Frederick J.A. (author)
- Radboud University Medical Center
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- Antonelli, Massimo (author)
- Policlinico Universitario Agostino Gemelli,Catholic University of the Sacred Heart, Rome
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- Hirsch, Karen G. (author)
- Stanford University
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Soar, Jasmeet (author)
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- Nolan, Jerry P. (author)
- Royal United Hospital, Bath
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- Cronberg, Tobias (author)
- Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,Brain Injury After Cardiac Arrest,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- 2022-03-04
- 2022
- English 25 s.
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In: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 48:4, s. 389-413
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Abstract
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- Purpose: To assess the ability of clinical examination, blood biomarkers, electrophysiology or neuroimaging assessed within 7 days from return of spontaneous circulation (ROSC) to predict good neurological outcome, defined as no, mild, or moderate disability (CPC 1–2 or mRS 0–3) at discharge from intensive care unit or later, in comatose adult survivors from cardiac arrest (CA). Methods: PubMed, EMBASE, Web of Science and the Cochrane Database of Systematic Reviews were searched. Sensitivity and specificity for good outcome were calculated for each predictor. The risk of bias was assessed using the QUIPS tool. Results: A total of 37 studies were included. Due to heterogeneities in recording times, predictor thresholds, and definition of some predictors, meta-analysis was not performed. A withdrawal or localisation motor response to pain immediately or at 72–96 h after ROSC, normal blood values of neuron-specific enolase (NSE) at 24 h-72 h after ROSC, a short-latency somatosensory evoked potentials (SSEPs) N20 wave amplitude > 4 µV or a continuous background without discharges on electroencephalogram (EEG) within 72 h from ROSC, and absent diffusion restriction in the cortex or deep grey matter on MRI on days 2–7 after ROSC predicted good neurological outcome with more than 80% specificity and a sensitivity above 40% in most studies. Most studies had moderate or high risk of bias. Conclusions: In comatose cardiac arrest survivors, clinical, biomarker, electrophysiology, and imaging studies identified patients destined to a good neurological outcome with high specificity within the first week after cardiac arrest (CA).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Cardiac arrest
- Clinical examination
- Coma
- Computed tomography
- Diffusion magnetic resonance imaging
- Electroencephalogram
- Neuron specific enolase
- Prognosis
- Somatosensory evoked potentials
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Sandroni, Claudi ...
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D’Arrigo, Sonia
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Cacciola, Sofia
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Hoedemaekers, Co ...
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Westhall, Erik
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Kamps, Marlijn J ...
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show more...
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Taccone, Fabio S ...
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Poole, Daniele
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Meijer, Frederic ...
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Antonelli, Massi ...
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Hirsch, Karen G.
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Soar, Jasmeet
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Nolan, Jerry P.
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Cronberg, Tobias
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- MEDICAL AND HEALTH SCIENCES
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Intensive Care M ...
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Lund University