Prediction of outcome after cardiac arrest

Crit Care Med. 1987 Sep;15(9):820-5. doi: 10.1097/00003246-198709000-00004.

Abstract

Neurologic outcome of hypoxic ischemic coma after cardiac arrest was studied in 32 patients. Observations were made and samples collected 24 and 48 h after the ischemic insult. The Glasgow-Pittsburgh coma score was assessed for its prognostic value. Other variables studied were the EEG and adenylate kinase, lactate and glutathione in the cerebrospinal fluid (CSF). Outcome was termed good if the patients resumed an independent life within a 6-month follow-up period. The closest correlations between prediction and good outcome occurred with the Glasgow-Pittsburgh coma score (94%) and the EEG (77%) at the 48-h examination, a modified coma score (96%) at 48 h, and CSF lactate (78%) at 24 h. Some simple neurologic signs (e.g., no withdrawal response to pain) at stated points in time was 100% associated with a bad outcome, although their absence was not associated necessarily with a good prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenylate Kinase / cerebrospinal fluid
  • Adult
  • Aged
  • Brain Damage, Chronic / diagnosis
  • Brain Damage, Chronic / etiology
  • Coma / classification
  • Coma / etiology*
  • Coma / physiopathology
  • Electroencephalography
  • Female
  • Glutathione / cerebrospinal fluid
  • Heart Arrest / complications*
  • Humans
  • Lactates / cerebrospinal fluid
  • Lactic Acid
  • Male
  • Middle Aged
  • Prognosis

Substances

  • Lactates
  • Lactic Acid
  • Adenylate Kinase
  • Glutathione