scholarly journals Independent Functional Outcomes after Prolonged Coma following Cardiac Arrest: A Mechanistic Hypothesis

2020 ◽  
Vol 87 (4) ◽  
pp. 618-632 ◽  
Author(s):  
Peter B. Forgacs ◽  
Orrin Devinsky ◽  
Nicholas D. Schiff
Keyword(s):  
Cardiac Arrest ◽  
Functional Outcomes ◽  
Prolonged Coma

scholarly journals Quality of Life and Functional Outcomes 12 Months After Out-of-Hospital Cardiac Arrest

Circulation ◽  
2015 ◽  
Vol 131 (2) ◽  
pp. 174-181 ◽  
Author(s):  
Karen Smith ◽  
Emily Andrew ◽  
Marijana Lijovic ◽  
Ziad Nehme ◽  
Stephen Bernard
Keyword(s):  
Quality Of Life ◽  
Cardiac Arrest ◽  
Functional Outcomes ◽  
Hospital Cardiac Arrest

scholarly journals Excellent neurologic recovery after prolonged coma in a cardiac arrest patient with multiple poor prognostic indicators

Resuscitation ◽  
2017 ◽  
Vol 113 ◽  
pp. e11-e12 ◽  
Author(s):  
Jessica Weinstein ◽  
Arka N. Mallela ◽  
Benjamin S. Abella ◽  
Joshua M. Levine ◽  
Ramani Balu
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Arrest Patient ◽  
Prognostic Indicators ◽  
Neurologic Recovery ◽  
Prolonged Coma

scholarly journals Early myoclonus following anoxic brain injury

2018 ◽  
Vol 8 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Alexandra S. Reynolds ◽  
Benjamin Rohaut ◽  
Manisha G. Holmes ◽  
David Robinson ◽  
William Roth ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Functional Outcomes ◽  
Clinical Characteristics ◽  
Cerebral Performance Category ◽  
Adult Survivors ◽  
Performance Category ◽  
Clinical Criteria ◽  
Cortical Myoclonus ◽  
Electrographic Seizures ◽  
Video Eeg

BackgroundIt is unknown whether postanoxic cortical and subcortical myoclonus are distinct entities with different prognoses.MethodsIn this retrospective cohort study of 604 adult survivors of cardiac arrest over 8.5 years, we identified 111 (18%) patients with myoclonus. Basic demographics and clinical characteristics of myoclonus were collected. EEG reports, and, when available, raw video EEG, were reviewed, and all findings adjudicated by 3 authors blinded to outcomes. Myoclonus was classified as cortical if there was a preceding, time-locked electrographic correlate and otherwise as subcortical. Outcome at discharge was determined using Cerebral Performance Category.ResultsPatients with myoclonus had longer arrests with less favorable characteristics compared to patients without myoclonus. Cortical myoclonus occurred twice as often as subcortical myoclonus (59% vs 23%, respectively). Clinical characteristics during hospitalization did not distinguish the two. Rates of electrographic seizures were higher in patients with cortical myoclonus (43%, vs 8% with subcortical). Survival to discharge was worse for patients with myoclonus compared to those without (26% vs 39%, respectively), but did not differ between subcortical and cortical myoclonus (24% and 26%, respectively). Patients with cortical myoclonus were more likely to be discharged in a comatose state than those with subcortical myoclonus (82% vs 33%, respectively). Among survivors, good functional outcome at discharge was equally possible between those with cortical and subcortical myoclonus (12% and 16%, respectively).ConclusionsCortical and subcortical myoclonus are seen in every sixth patient with cardiac arrest and cannot be distinguished using clinical criteria. Either condition may have good functional outcomes.

scholarly journals Fixed, Dilated Pupils in the ICU: Another Recoverable Cause

2000 ◽  
Vol 28 (1) ◽  
pp. 91-93 ◽  
Author(s):  
S. Cordova ◽  
R. Lee
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Arrest ◽  
Intensive Care ◽  
Affective Disorder ◽  
Bipolar Affective Disorder ◽  
Unknown Quantity ◽  
Prolonged Coma ◽  
Massive Overdose

A 41-year-old woman presented unconscious with fixed dilated pupils following a massive overdose of carbamazepine and an unknown quantity of venlafaxine prescribed for the management of bipolar affective disorder. Her course in the intensive care unit was marked by a number of complications related to the overdose including prolonged coma, seizures and cardiac arrest. The patient eventually recovered to leave hospital.

Abstract 14806: Predictors of Survival and Favourable Functional Outcomes Following an Out of Hospital Cardiac Arrest in Patients Systematically Brought to a Dedicated Heart Attack Centre

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
M Bilal Iqbal ◽  
Abtehale Al-Hussaini ◽  
Gareth Rosser ◽  
Saleem Salehi ◽  
Maria Phylactou ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Functional Status ◽  
Heart Attack ◽  
Functional Outcomes ◽  
Emergency Services ◽  
Survival Rates ◽  
Spontaneous Circulation ◽  
Term Survival ◽  
Poor Functional Status ◽  
Hospital Cardiac Arrest

BACKGROUND: Despite advances in cardiopulmonary resuscitation, survival remains low after out of hospital cardiac arrest (OOHCA), with less than 20% of patients surviving to hospital discharge. Acute coronary ischaemia is the predominating cause and prompt delivery of patients to dedicated facilities may improve outcomes. Since 2011, all patients in London with OOHCA, in whom a cardiac aetiology is suspected, are brought to dedicated Heart Attack Centres (HACs). OBJECTIVES: We sought to determine the predictors for survival and favourable functional outcomes following OOHCA in this setting. METHODS: We analysed 182 consecutive OOHCA patients brought by the emergency services to Harefield Hospital - a designated HAC in London. Of these, 174 patients achieved return of spontaneous circulation. We analysed (a) all-cause mortality at 1 year; and (b) functional status at discharge using a modified Rankins score (mRS:0-6, where mRS0-3=favourable functional status). We used multivariate models to determine predictors of survival and favourable functional status. RESULTS: The overall survival rates were 66.7% at 30 days and 62.1% at 1 year. Of the 174 patients, 95 patients (54.5%) had favourable functional status at discharge. Patients with favourable functional status had significantly reduced mortality rates compared to those with poor functional status: 30 days (1.2% vs. 72.2%, p<0.001) and 1 year (5.3% vs. 77.2%, p<0.001). Multivariate analyses identified a shorter duration of resuscitation and absence of cardiogenic shock as consistent independent predictors of both favourable functional status and long-term survival (figure). CONCLUSIONS: The strategic delivery of OOHCA patients to HACs is associated with improved functional status and survival. Those with favourable functional status at discharge have significantly improved survival. Our study supports the standardisation of care for such patients with the widespread adoption of dedicated facilities.

scholarly journals Quantitative assessment of somatosensory-evoked potentials after cardiac arrest in rats: Prognostication of functional outcomes*

2010 ◽  
Vol 38 (8) ◽  
pp. 1709-1717 ◽  
Author(s):  
Jai Madhok ◽  
Anil Maybhate ◽  
Wei Xiong ◽  
Matthew A. Koenig ◽  
Romergryko G. Geocadin ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Evoked Potentials ◽  
Somatosensory Evoked Potentials ◽  
Functional Outcomes ◽  
Quantitative Assessment
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