Poor outcome was defined as: death; unconsciousness after one month; or unconsciousness or severe disability after six months.
"This guideline will help physicians predict the outcome for these patients and then communicate that information to family members," said guideline author Eelco Wijdicks, MD, of the Mayo Clinic in Rochester, MN.
To develop the guideline, the authors reviewed all of the available scientific studies on the topic.
The main tools to predict outcome are the doctor's clinical examination of the patient and laboratory tests.
"Certain tests have a false positive rate of zero," Wijdicks said. "This means that if the test determines that the person will have a poor outcome, there is virtually no chance that the test is incorrect."
Wijdicks also noted that there are currently no tests that accurately predict which patients will have a good outcome.
Tests that are strong predictors of poor outcome include absent pupillary reflexes or corneal reflexes. The pupil, the black part of the eye, usually gets smaller when light is held in front of it. The eye normally blinks when the cornea, or the clear part of the eye, is touched with a small piece of cotton or dripping water solution.
Absent or extensor motor responses three days after cardiac arrest are another strong predictor of poor outcome. An absent motor response means there is no movement in response to pain. An extensor motor response is a reflex movement with straightening of the arms and legs. The movement happens on its own or in response to pain.
The guidelines also determined that some factors and tests are not good predictors of poor outcome from coma. The circumstances surrounding CPR, such as how long CPR is conducted, the cause of the cardiac arrest, and the amount of time that passes between the cardiac arrest and the start of CPR do not accurately predict the outcome from coma.
"In the midst of a catastrophe, families are subsumed with grief from an ordeal that undermines all their coping mechanisms," Wijdicks said. "It's important for family members to talk with a neurologist when faced with this situation. Neurologists can provide accurate information about assessment and the likelihood of recovery. If the probability of devastating neurological disability is high, family members may prefer no further resuscitation, no surgical interventions or the withdrawal of critical care. These decisions should be made after understanding the patient's prior advance directives, or instructions for what type of care the patient would like to receive."
Angela Babb | EurekAlert!
How cancer metastasis happens: Researchers reveal a key mechanism
19.01.2018 | Weill Cornell Medicine
Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
19.01.2018 | Materials Sciences
19.01.2018 | Health and Medicine
19.01.2018 | Physics and Astronomy