Performance of a guideline-recommended algorithm for prognostication of poor neurological outcome after cardiac arrest
Purpose To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Methods Retrospective descriptive analysis with data from the Target Temp...
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| Published in | Intensive care medicine Vol. 46; no. 10; pp. 1852 - 1862 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Berlin/Heidelberg
Springer Berlin Heidelberg
01.10.2020
Springer Springer Nature B.V |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0342-4642 1432-1238 1432-1238 |
| DOI | 10.1007/s00134-020-06080-9 |
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| Abstract | Purpose
To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM).
Methods
Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72–96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3–5. Variations of the ERC/ESICM algorithm were explored within the same cohort.
Results
The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1–44.7) and 100% specificity (95% CI 98.8–100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7–48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8–100) remaining.
Conclusion
The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6–42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. |
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| AbstractList | PurposeTo assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM).MethodsRetrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72–96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3–5. Variations of the ERC/ESICM algorithm were explored within the same cohort.ResultsThe ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1–44.7) and 100% specificity (95% CI 98.8–100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7–48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8–100) remaining.ConclusionThe ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6–42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72-96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3-5. Variations of the ERC/ESICM algorithm were explored within the same cohort. The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1-44.7) and 100% specificity (95% CI 98.8-100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7-48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8-100) remaining. The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6-42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM).PURPOSETo assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM).Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72-96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3-5. Variations of the ERC/ESICM algorithm were explored within the same cohort.METHODSRetrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72-96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3-5. Variations of the ERC/ESICM algorithm were explored within the same cohort.The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1-44.7) and 100% specificity (95% CI 98.8-100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7-48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8-100) remaining.RESULTSThe ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1-44.7) and 100% specificity (95% CI 98.8-100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7-48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8-100) remaining.The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6-42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies.CONCLUSIONThe ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6-42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. Purpose To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Methods Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72–96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3–5. Variations of the ERC/ESICM algorithm were explored within the same cohort. Results The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1–44.7) and 100% specificity (95% CI 98.8–100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7–48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8–100) remaining. Conclusion The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6–42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72-96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3-5. Variations of the ERC/ESICM algorithm were explored within the same cohort. The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1-44.7) and 100% specificity (95% CI 98.8-100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7-48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8-100) remaining. The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6-42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. © 2020, The Author(s). Purpose: To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Methods: Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72–96h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3–5. Variations of the ERC/ESICM algorithm were explored within the same cohort. Results: The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1–44.7) and 100% specificity (95% CI 98.8–100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7–48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8–100) remaining. Conclusion: The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6–42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. Purpose To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Methods Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72-96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3-5. Variations of the ERC/ESICM algorithm were explored within the same cohort. Results The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1-44.7) and 100% specificity (95% CI 98.8-100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7-48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8-100) remaining. Conclusion The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6-42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. Purpose: To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM). Methods: Retrospective descriptive analysis with data from the Target Temperature Management (TTM) Trial. Associations between predicted and actual neurological outcome were investigated for each step of the algorithm with results from clinical neurological examinations, neuroradiology (CT or MRI), neurophysiology (EEG and SSEP) and serum neuron-specific enolase. Patients examined with Glasgow Coma Scale Motor Score (GCS-M) on day 4 (72–96 h) post-arrest and available 6-month outcome were included. Poor outcome was defined as Cerebral Performance Category 3–5. Variations of the ERC/ESICM algorithm were explored within the same cohort. Results: The ERC/ESICM algorithm identified poor outcome patients with 38.7% sensitivity (95% CI 33.1–44.7) and 100% specificity (95% CI 98.8–100) in a cohort of 585 patients. An alternative cut-off for serum neuron-specific enolase, an alternative EEG-classification and variations of the GCS-M had minor effects on the sensitivity without causing false positive predictions. The highest overall sensitivity, 42.5% (95% CI 36.7–48.5), was achieved when prognosticating patients irrespective of GCS-M score, with 100% specificity (95% CI 98.8–100) remaining. Conclusion: The ERC/ESICM algorithm and all exploratory multimodal variations thereof investigated in this study predicted poor outcome without false positive predictions and with sensitivities 34.6–42.5%. Our results should be validated prospectively, preferably in patients where withdrawal of life-sustaining therapy is uncommon to exclude any confounding from self-fulfilling prophecies. |
| Audience | Academic |
| Author | Cronberg, Tobias Moseby-Knappe, Marion Dragancea, Irina Mattsson-Carlgren, Niklas Hassager, Christian Rylander, Christian Ullén, Susann Kjaergaard, Jesper Lybeck, Anna Horn, Janneke Lilja, Gisela Westhall, Erik Friberg, Hans Stammet, Pascal Nielsen, Niklas Backman, Sofia |
| Author_xml | – sequence: 1 givenname: Marion orcidid: 0000-0001-8160-5957 surname: Moseby-Knappe fullname: Moseby-Knappe, Marion email: marion.moseby_knappe@med.lu.se organization: Department of Clinical Sciences Lund, Neurology, Skåne University Hospital, Lund University – sequence: 2 givenname: Erik surname: Westhall fullname: Westhall, Erik organization: Department of Clinical Sciences Lund, Clinical Neurophysiology, Skane University Hospital, Lund University – sequence: 3 givenname: Sofia surname: Backman fullname: Backman, Sofia organization: Department of Clinical Sciences Lund, Clinical Neurophysiology, Skane University Hospital, Lund University – sequence: 4 givenname: Niklas surname: Mattsson-Carlgren fullname: Mattsson-Carlgren, Niklas organization: Department of Clinical Sciences Lund, Neurology, Skåne University Hospital, Lund University, Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Wallenberg Center for Molecular Medicine, Lund University – sequence: 5 givenname: Irina surname: Dragancea fullname: Dragancea, Irina organization: Department of Clinical Sciences Lund, Neurology, Skåne University Hospital, Lund University – sequence: 6 givenname: Anna surname: Lybeck fullname: Lybeck, Anna organization: Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Skane University Hospital, Lund University – sequence: 7 givenname: Hans surname: Friberg fullname: Friberg, Hans organization: Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Skane University Hospital, Lund University – sequence: 8 givenname: Pascal surname: Stammet fullname: Stammet, Pascal organization: Medical and Health Department, National Fire and Rescue Corps – sequence: 9 givenname: Gisela surname: Lilja fullname: Lilja, Gisela organization: Department of Clinical Sciences Lund, Neurology, Skåne University Hospital, Lund University – sequence: 10 givenname: Janneke surname: Horn fullname: Horn, Janneke organization: Department of Intensive Care, Amsterdam UMC, Location Academic Medical Center – sequence: 11 givenname: Jesper surname: Kjaergaard fullname: Kjaergaard, Jesper organization: Department of Cardiology, Rigshospitalet and Department of Clinical Medicine,, University of Copenhagen – sequence: 12 givenname: Christian surname: Rylander fullname: Rylander, Christian organization: Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg – sequence: 13 givenname: Christian surname: Hassager fullname: Hassager, Christian organization: Department of Cardiology, Rigshospitalet and Department of Clinical Medicine,, University of Copenhagen – sequence: 14 givenname: Susann surname: Ullén fullname: Ullén, Susann organization: Clinical Studies Sweden - Forum South, Skane University Hospital – sequence: 15 givenname: Niklas surname: Nielsen fullname: Nielsen, Niklas organization: Department of Clinical Sciences Lund, Anaesthesia and Intensive Care, Helsingborg Hospital, Lund University – sequence: 16 givenname: Tobias surname: Cronberg fullname: Cronberg, Tobias organization: Department of Clinical Sciences Lund, Neurology, Skåne University Hospital, Lund University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32494928$$D View this record in MEDLINE/PubMed https://gup.ub.gu.se/publication/294263$$DView record from Swedish Publication Index |
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| CorporateAuthor | Centrum för hjärtstopp WCMM-Wallenberg Centre for Molecular Medicine WCMM- Wallenberg center för molekylär medicinsk forskning Department of Clinical Sciences, Lund Clinical Sciences, Helsingborg Neurology, Lund Strategiska forskningsområden (SFO) Anesthesiology and Intensive Care Clinical Memory Research Klinisk minnesforskning Section IV Medicinska fakulteten Sektion IV Clinical Neurophysiology Center for cardiac arrest Neurologi, Lund Institutionen för kliniska vetenskaper, Lund Sektion II MultiPark: Multidisciplinary research focused on Parkinson's disease Kliniska Vetenskaper, Helsingborg Brain Injury After Cardiac Arrest Lunds universitet Section II Profile areas and other strong research environments Department of Clinical Sciences, Malmö Lund University Faculty of Medicine Strategic research areas (SRA) Klinisk neurofysiologi Anestesiologi och intensivvård Profilområden och andra starka forskningsmiljöer SWECRIT Institutionen för kliniska vetenskaper, Malmö |
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| Keywords | Coma Prognostication Guideline algorithm Cardiac arrest Prognostic accuracy |
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| License | Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/. |
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on 1,053 patients publication-title: Crit Care Med doi: 10.1097/CCM.0000000000002335 – volume: 65 start-page: 2104 issue: 19 year: 2015 end-page: 2114 ident: CR7 article-title: Neuron-specific enolase as a predictor of death or poor neurological outcome after out-of-hospital cardiac arrest and targeted temperature management at 33°C and 36°C publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2015.03.538 – volume: 132 start-page: S465 issue: 18 Suppl 2 year: 2015 end-page: S482 ident: CR27 article-title: Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care publication-title: Circulation doi: 10.1161/CIR.0000000000000262 – volume: 45 start-page: e674 issue: 7 year: 2017 end-page: e682 ident: CR5 article-title: Electroencephalography predicts poor and good outcomes after cardiac arrest: a two-center study publication-title: Crit Care Med doi: 10.1097/ccm.0000000000002337 – volume: 67 start-page: 203 issue: 2 year: 2006 end-page: 210 ident: CR17 article-title: Practice parameter: prediction of outcome in comatose survivors after cardiopulmonary resuscitation (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology publication-title: Neurology doi: 10.1212/01.wnl.0000227183.21314.cd – volume: 41 start-page: 2039 issue: 12 year: 2015 end-page: 2056 ident: CR41 article-title: European resuscitation council and european society of intensive care medicine 2015 guidelines for post-resuscitation care publication-title: Intensive Care Med doi: 10.1007/s00134-015-4051-3 – volume: 85 start-page: 1779 issue: 12 year: 2014 end-page: 1789 ident: CR1 article-title: Prognostication in comatose survivors of cardiac arrest: an advisory statement from the European Resuscitation Council and the European Society of Intensive Care Medicine publication-title: Resuscitation doi: 10.1016/j.resuscitation.2014.08.011 – volume: 126 start-page: 2397 issue: 12 year: 2015 end-page: 2404 ident: CR16 article-title: Interrater variability of EEG interpretation in comatose cardiac arrest patients publication-title: Clin Neurophysiol doi: 10.1016/j.clinph.2015.03.017 – volume: 20 start-page: 266 issue: 3 year: 2014 end-page: 272 ident: CR40 article-title: The impact of oxygen and carbon dioxide management on outcome after cardiac arrest publication-title: Curr Opin Crit Care doi: 10.1097/MCC.0000000000000084 – volume: 66 start-page: 62 issue: 1 year: 2006 end-page: 68 ident: CR18 article-title: Prediction of poor outcome within the first 3 days of postanoxic coma publication-title: Neurology doi: 10.1212/01.wnl.0000191308.22233.88 – volume: 44 start-page: 2102 issue: 12 year: 2018 end-page: 2111 ident: CR36 article-title: Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: an international prospective multicenter double-blinded study publication-title: 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issue: 7905 year: 1975 end-page: 484 ident: CR13 article-title: Assessment of outcome after severe brain damage publication-title: Lancet doi: 10.1016/s0140-6736(75)92830-5 – volume: 84 start-page: 1310 issue: 10 year: 2013 end-page: 1323 ident: CR29 article-title: Predictors of poor neurological outcome in adult comatose survivors of cardiac arrest: a systematic review and meta-analysis. Part 1: patients not treated with therapeutic hypothermia publication-title: Resuscitation doi: 10.1016/j.resuscitation.2013.05.013 – volume: 135 start-page: 145 year: 2019 end-page: 152 ident: CR6 article-title: Post resuscitation prognostication by EEG in 24 vs 48 h of targeted temperature management publication-title: Resuscitation doi: 10.1016/j.resuscitation.2018.10.035 – volume: 163 start-page: 541 issue: 4 year: 2012 end-page: 548 ident: CR9 article-title: Target temperature management after out-of-hospital cardiac arrest—a randomized, parallel-group, assessor-blinded clinical trial—rationale and design publication-title: Am Heart J doi: 10.1016/j.ahj.2012.01.013 – volume: 131 start-page: 24 year: 2018 end-page: 28 ident: CR4 article-title: Highly malignant routine EEG predicts poor prognosis after cardiac arrest in the Target Temperature Management trial publication-title: Resuscitation doi: 10.1016/j.resuscitation.2018.07.024 – volume: 369 start-page: 2197 issue: 23 year: 2013 end-page: 2206 ident: CR10 article-title: Targeted temperature management at 33°C versus 36°C after cardiac arrest publication-title: N Engl J Med doi: 10.1056/NEJMoa1310519 – year: 2020 ident: CR32 article-title: Corneal reflex testing in the evaluation of a comatose patient: an Ode to precise semiology and examination skills publication-title: Neurocrit Care doi: 10.1007/s12028-019-00896-0 – volume: 86 start-page: 1482 issue: 16 year: 2016 end-page: 1490 ident: CR3 article-title: Standardized EEG interpretation accurately predicts prognosis after cardiac arrest publication-title: Neurology doi: 10.1212/wnl.0000000000002462 – volume: 76 start-page: 64 issue: 1 year: 2019 end-page: 71 ident: CR37 article-title: Serum neurofilament light chain for prognosis of outcome after cardiac arrest publication-title: JAMA Neurol doi: 10.1001/jamaneurol.2018.3223 – volume: 30 start-page: 1 issue: 1 year: 2013 end-page: 27 ident: CR15 article-title: American clinical neurophysiology society’s standardized critical care EEG terminology: 2012 version publication-title: J Clin Neurophysiol doi: 10.1097/WNP.0b013e3182784729 – ident: 6080_CR22 – volume: 46 start-page: e1213 issue: 12 year: 2018 ident: 6080_CR25 publication-title: Crit Care Med doi: 10.1097/CCM.0000000000003436 – volume: 86 start-page: 1482 issue: 16 year: 2016 ident: 6080_CR3 publication-title: Neurology doi: 10.1212/wnl.0000000000002462 – volume: 135 start-page: 145 year: 2019 ident: 6080_CR6 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2018.10.035 – volume: 93 start-page: 164 year: 2015 ident: 6080_CR11 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2015.04.013 – year: 2020 ident: 6080_CR19 publication-title: Intensive Care Med doi: 10.1007/s00134-019-05921-6 – volume: 67 start-page: 203 issue: 2 year: 2006 ident: 6080_CR17 publication-title: Neurology doi: 10.1212/01.wnl.0000227183.21314.cd – volume: 76 start-page: 64 issue: 1 year: 2019 ident: 6080_CR37 publication-title: JAMA Neurol doi: 10.1001/jamaneurol.2018.3223 – volume: 65 start-page: 2104 issue: 19 year: 2015 ident: 6080_CR7 publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2015.03.538 – volume: 119 start-page: 89 year: 2017 ident: 6080_CR21 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2017.06.027 – volume: 1 start-page: 480 issue: 7905 year: 1975 ident: 6080_CR13 publication-title: Lancet doi: 10.1016/s0140-6736(75)92830-5 – volume: 134 start-page: 33 year: 2019 ident: 6080_CR31 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2018.11.007 – volume: 82 start-page: 665 issue: 5 year: 2017 ident: 6080_CR38 publication-title: Ann Neurol doi: 10.1002/ana.25067 – volume: 163 start-page: 541 issue: 4 year: 2012 ident: 6080_CR9 publication-title: Am Heart J doi: 10.1016/j.ahj.2012.01.013 – volume: 369 start-page: 2197 issue: 23 year: 2013 ident: 6080_CR10 publication-title: N Engl J Med doi: 10.1056/NEJMoa1310519 – volume: 41 start-page: 2039 issue: 12 year: 2015 ident: 6080_CR41 publication-title: Intensive Care Med doi: 10.1007/s00134-015-4051-3 – volume: 147 start-page: 95 year: 2020 ident: 6080_CR30 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2019.11.014 – volume: 145 start-page: 8 year: 2019 ident: 6080_CR33 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2019.09.025 – volume: 85 start-page: 1779 issue: 12 year: 2014 ident: 6080_CR1 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2014.08.011 – volume: 80 start-page: 175 issue: 2 year: 2016 ident: 6080_CR23 publication-title: Ann Neurol doi: 10.1002/ana.24697 – volume: 84 start-page: 1310 issue: 10 year: 2013 ident: 6080_CR29 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2013.05.013 – volume: 30 start-page: 1 issue: 1 year: 2013 ident: 6080_CR15 publication-title: J Clin Neurophysiol doi: 10.1097/WNP.0b013e3182784729 – volume: 45 start-page: 1145 issue: 7 year: 2017 ident: 6080_CR8 publication-title: Crit Care Med doi: 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81 start-page: 804 issue: 6 year: 2017 ident: 6080_CR35 publication-title: Ann Neurol doi: 10.1002/ana.24943 – volume: 41 start-page: 2204 issue: 12 year: 2015 ident: 6080_CR2 publication-title: Intensive Care Med doi: 10.1007/s00134-015-4094-5 – volume: 114 start-page: 146 year: 2017 ident: 6080_CR14 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2017.01.017 – volume: 20 start-page: 266 issue: 3 year: 2014 ident: 6080_CR40 publication-title: Curr Opin Crit Care doi: 10.1097/MCC.0000000000000084 – volume: 131 start-page: 24 year: 2018 ident: 6080_CR4 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2018.07.024 – volume: 66 start-page: 62 issue: 1 year: 2006 ident: 6080_CR18 publication-title: Neurology doi: 10.1212/01.wnl.0000191308.22233.88 – year: 2020 ident: 6080_CR32 publication-title: Neurocrit Care doi: 10.1007/s12028-019-00896-0 – year: 2019 ident: 6080_CR20 publication-title: Resuscitation doi: 10.1016/j.resuscitation.2019.03.035 – volume: 67 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To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council... To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council (ERC)... Purpose To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council... PurposeTo assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation Council... © 2020, The Author(s). Purpose: To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the... Purpose: To assess the performance of a 4-step algorithm for neurological prognostication after cardiac arrest recommended by the European Resuscitation... |
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| SubjectTerms | Algorithms Anestesi och intensivvård Anesthesiology Anesthesiology and Intensive Care Cardiac arrest Cardiology and Cardiovascular Disease Clinical Medicine Clinical outcomes Coma Critical Care Medicine EEG Electroencephalography Emergency Medicine Guideline algorithm Heart Heart attacks Humans Hypothermia, Induced Intensive Intensive care Kardiologi och kardiovaskulära sjukdomar Klinisk medicin Magnetic resonance imaging Medical and Health Sciences Medical prognosis Medicin och hälsovetenskap Medicine Medicine & Public Health Neuroimaging Neurologi Neurology Neurophysiology Original Out-of-Hospital Cardiac Arrest - therapy Pain Medicine Pediatrics Phosphopyruvate Hydratase Pneumology/Respiratory System Predictions Prognosis Prognostic accuracy Prognostication Resuscitation Retrospective Studies Sensitivity Variation |
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| Title | Performance of a guideline-recommended algorithm for prognostication of poor neurological outcome after cardiac arrest |
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