[Evaluation of coma after cardiopulmonary resuscitation]. 2005

Ying-ying Su, and Qing-lin Yang, and Ying Pang, and Xiang-ping Lü
Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China. tangsuyingying@yahoo.com.cn

OBJECTIVE To investigate the accurate and objective methods of evaluating coma after cardiopulmonary resuscitation. METHODS Cases that were still in coma 24 hours after cardiopulmonary resuscitation were continuously observed and evaluated between April 2002 and November 2004. The methods of evaluation included various clinical examinations, for instance conscious state, Glasgow coma score (GCS), brain stem inflection, spinal reflexes and so on. Other methods of evaluation included laboratory examinations, such as electroencephalography (EEG), brain auditory evoked potential (BAEP), short latent somatosensory evoked potential (SLSEP) and transcranial doppler (TCD). RESULTS 24 of a series of 35 cases (68.6%) were in deep coma. The GCS is score 3. EEG evaluated was not less than grade IV in all except 4; BAEP evaluated was grade III in all except 3; SLSEP evaluated was grade III in all except 1. 24 cases died within 1 month and 11 of them (45.8%) were evaluated as having brain death and Glasgow outcome score (GOS) was grade I. 11 of the 35 cases survived and their state of consciousness changed from deep coma to coma vigil, EEG evaluated was grade I in 5 cases. BAEP and SLSEP were grade I in the 3 cases evaluated and GOS is grade II. 2 cases (18.2%) regain consciousness at the time of 35 and 90 days after cardiopulmonary resuscitation and their GOS was grade IV and grade III respectively. CONCLUSIONS Combined and continuous observation of clinical manifestations and laboratory parameters can accurately and objectively evaluate coma after cardiopulmonary resuscitation.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D001926 Brain Death A state of prolonged irreversible cessation of all brain activity, including lower brain stem function with the complete absence of voluntary movements, responses to stimuli, brain stem reflexes, and spontaneous respirations. Reversible conditions which mimic this clinical state (e.g., sedative overdose, hypothermia, etc.) are excluded prior to making the determination of brain death. (From Adams et al., Principles of Neurology, 6th ed, pp348-9) Brain Dead,Coma Depasse,Irreversible Coma,Brain Deads,Coma, Irreversible,Death, Brain
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D005073 Evoked Potentials, Somatosensory The electric response evoked in the CEREBRAL CORTEX by stimulation along AFFERENT PATHWAYS from PERIPHERAL NERVES to CEREBRUM. Somatosensory Evoked Potentials,Evoked Potential, Somatosensory,Somatosensory Evoked Potential
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths

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