Prediction of Poor Outcome in Comatose Survivors after Cardiopulmonary Resuscitation with Somatosensory Evoked Potentials and Proton Magnetic Resonance Spectroscopy.
- Author:
Seung Pil CHOI
1
;
In Young OH
;
Young Min KIM
;
Kyu Nam PARK
;
Si Kyoung JEONG
;
Guk Jin ANN
;
Choon Ho SUNG
;
Won Jae LEE
;
Se Kyung KIM
Author Information
1. Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. emsky@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Cardiopulmonary resuscitation;
Somatosensory evoked potential;
Magnetic resonance spectroscopy
- MeSH:
Cardiopulmonary Resuscitation*;
Coma*;
Evoked Potentials, Somatosensory*;
Heart Arrest;
Humans;
Magnetic Resonance Spectroscopy*;
Protons*;
Sensitivity and Specificity;
Survivors*
- From:Journal of the Korean Society of Emergency Medicine
2004;15(6):456-462
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The study was conducted to examine the usefulness of somatosensory evoked potentials (SEP) and proton magnetic resonance spectroscopy (1H-MRS) in predicting poor outcomes for comatose survivors after cardiopulmonary resuscitation. METHODS: We investigated 36 patients who were comatose after cardiac arrest. Among them, 35 had short latency SEP, and 27 had 1H-MRS. Both tests were performed in 26 patients. To estimate the cerebral outcome, we used the cerebral performance category (CPC) to classify the outcomes for our patients as good (CPC 1-2) or poor (CPC 3-5). RESULTS: Of the 36 patients, 11(31%) presented with good outcomes (CPC 1-2). A bilaterally absent N20 peak (n=35) predicted poor outcomes with a sensitivity of 54.2% and a specificity of 100%. A lactate-positive resonance (n=27) predicted poor outcomes with a sensitivity of 78.9% and a specificity of 100%. Using a combination of a bilaterally absent N20 peak and a lactate-positive resonance (n=26) predicted poor outcomes with a sensitivity of 94.4% and a specificity of 100%. CONCLUSION: The combination of a bilaterally absent N20 peak and a lactate-positive resonance is better than either alone in predicting poor outcomes in patients who are comatose after cardiac arrest.
