title: Prediction of outcome after hypoxic-ischemic encephalopathy: a prospective clinical and electrophysiologic study.
abstract: OBJECTIVE
  To evaluate and compare the predictive value of history, clinical examination, and biologic and electrophysiologic data regarding the prognosis of children with acute hypoxic-ischemic encephalopathy (HIE).
  
  
  METHODS
  Prospective cohort of 57 consecutive children who were mechanically ventilated for HIE throughout a 3-year period in a tertiary pediatric intensive care unit at a university hospital in France.
  
  
  RESULTS
  At 24 hours after admission, 12 patients had died, 3 were awake and 42 showed impaired consciousness or were in a coma, of whom 38% had a favorable outcome. In this group, an initial cardiopulmonary resuscitation duration longer than 10 minutes and a Glasgow Coma Scale <5 at 24 hours after admission were associated with an unfavorable outcome (positive predictive value [PPV] 91%, 100%; sensitivity 50%, 54%). A discontinuous electroencephalogram (EEG), the presence of spikes or epileptiform discharges were associated with an unfavorable outcome (PPV 100% for the 2 criteria; sensitivity 27%, 54%). The bilateral absence of the N20 wave on short-latency sensory evoked potentials (SEPs) had a PPV for unfavorable outcome of 100% (sensitivity 63%).
  
  
  CONCLUSIONS
  The clinical assessment combined with EEG and SEPs allow an early prediction of the prognosis of children with HIE.
authors.affiliation: Pediatric Intensive Care Unit, the Department of Neurophysiology, University Hospital of Lille, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Mandel
authors.forename: Alain
authors.initials: A
authors.lastname: Martinot
authors.forename: Florence
authors.initials: F
authors.lastname: Delepoulle
authors.forename: Marie-Dominique
authors.initials: MD
authors.lastname: Lamblin
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Laureau
authors.forename: Louis
authors.initials: L
authors.lastname: Vallee
authors.forename: Francis
authors.initials: F
authors.lastname: Leclerc
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis*; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric