[Prognosis for patients in a coma following cardiopulmonary resuscitation].
Most patients with post-anoxic coma after resuscitation have a poor prognosis. Reliable prediction of poor outcomes (death or vegetative state after 1 month; death, vegetative state or severe disability after at least 6 months) at an early stage is important for both family members and treating physicians. Poor outcome can be predicted with 100% reliability in the first 3 days after resuscitation in about 80% of patients using pupillary and corneal reflexes and motor response from the neurological examination, cortical responses from somatosensory evoked potentials and EEG. The predictive value of a status epilepticus or serum levels of neuron-specific enolase is uncertain at this time. In contrast to poor outcomes, good neurological recovery cannot be predicted reliably at this time.
Horn
J
J
Afd. Intensive Care, Academisch Medisch Centrum/Universiteit van Amsterdam, Postbus 22.700, 1100 DE Amsterdam. j.horn@amc.uva.nl
Zandbergen
E G J
EG
Koelman
J H T M
JH
Hijdra
A
A
D016887:Cardiopulmonary Resuscitation / Q000706:statistics & numerical data*; D003128:Coma / Q000401:mortality* / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D017741:Survivors