Cerebral prognostic signs during cardiopulmonary resuscitation. 1978

E O Jørgensen, and A M Malchow-Møller

In 54 patients with circulatory arrest mainly due to ischaemic heart disease cerebral functions were tested longitudinally during primary cardiopulmonary resuscitation or basic life support. Cerebral recovery was characterized by the appearance of functions in caudorostral sequence. Cerebral prognosis was reliably assessed by the time to reappearance of respiratory movements, pupillary light, coughing--swallowing and ciliospinal reflexes, as these were regained within critical time limits of 7, 12, 23 and 26 min respectively, corresponding to the longest delay compatible with recovery of consciousness and within ultimate time limits of 15, 28, 58 and 52 min corresponding to the longest delay compatible with any cerebral recovery at all. Prognostication was currently ascertained during basic life support as reflex reappearance times were exponentially interdependent. If circulation was re-established it usually happened within less than 20 min of basic life support. Prolongation of the resuscitation attempt beyond this time occasionally resulted in a selective reestablishment of circulation (brain death) but most often resulted in a dissociated recovery of cerebral functions (cardiac death).

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D012151 Resuscitation The restoration to life or consciousness of one apparently dead. (Dorland, 27th ed) Resuscitations
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
D002545 Brain Ischemia Localized reduction of blood flow to brain tissue due to arterial obstruction or systemic hypoperfusion. This frequently occurs in conjunction with brain hypoxia (HYPOXIA, BRAIN). Prolonged ischemia is associated with BRAIN INFARCTION. Cerebral Ischemia,Ischemic Encephalopathy,Encephalopathy, Ischemic,Ischemia, Cerebral,Brain Ischemias,Cerebral Ischemias,Ischemia, Brain,Ischemias, Cerebral,Ischemic Encephalopathies
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
D005260 Female Females
D006323 Heart Arrest Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation. Asystole,Cardiac Arrest,Cardiopulmonary Arrest,Arrest, Cardiac,Arrest, Cardiopulmonary,Arrest, Heart,Asystoles

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