title: Time-dependency of sensory evoked potentials in comatose cardiac arrest survivors.
abstract: OBJECTIVE
  To assess the validity of early sensory evoked potential (SEP) recording for reliable outcome prediction in comatose cardiac arrest survivors within 48 h after restoration of spontaneous circulation (ROSC).
  
  
  METHODS
  Prospective cohort study in a medical intensive care unit of a university hospital.
  
  
  METHODS
  Twenty-five comatose, mechanically ventilated patients following cardiopulmonary resuscitation
  
  
  RESULTS
  Median nerve short- and long-latency SEP were recorded 4, 12, 24, and 48 h after ROSC. Cortical N20 peak latency and cervicomedullary conduction time decreased (improved) significantly between 4, 12, and 24 h after resuscitation in 22 of the enrolled patients. There was no further change in short-latency SEP at 48 h. The cortical N70 peak was initially detectable in seven patients. The number of patients with increased N70 peak increased to 11 at 12 h and 14 at 24 h; there was no further change at 48 h. Specificity of the N70 peak latency (critical cutoff 130 ms) increased from 0.43 at 4 h to 1.0 at 24 h after ROSC. Sensitivity decreased from 1.0 at 4 h to 0.83 at 24 h after ROSC.
  
  
  CONCLUSIONS
  Within 24 h after ROSC there was a significant improvement in SEP. Therefore we recommend allowing a period of at least 24 h after cardiopulmonary resuscitation for obtaining a reliable prognosis based on SEP.
authors.affiliation: Department of Internal Medicine IV, Intensive Care Unit 13 H1, University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. alexandra.gendo@univie.ac.at
authors.forename: A
authors.initials: A
authors.lastname: Gendo
authors.forename: L
authors.initials: L
authors.lastname: Kramer
authors.forename: M
authors.initials: M
authors.lastname: Häfner
authors.forename: G C
authors.initials: GC
authors.lastname: Funk
authors.forename: C
authors.initials: C
authors.lastname: Zauner
authors.forename: F
authors.initials: F
authors.lastname: Sterz
authors.forename: M
authors.initials: M
authors.lastname: Holzer
authors.forename: E
authors.initials: E
authors.lastname: Bauer
authors.forename: C
authors.initials: C
authors.lastname: Madl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001317:Austria / Q000453:epidemiology; D016887:Cardiopulmonary Resuscitation; D003128:Coma / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013997:Time Factors