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!
Biofilm discovery suggests new way to prevent dangerous infections
23.05.2017 | University of Texas at Austin
Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care
Scientists have developed a new method of characterizing graphene’s properties without applying disruptive electrical contacts, allowing them to investigate both the resistance and quantum capacitance of graphene and other two-dimensional materials. Researchers from the Swiss Nanoscience Institute and the University of Basel’s Department of Physics reported their findings in the journal Physical Review Applied.
Graphene consists of a single layer of carbon atoms. It is transparent, harder than diamond and stronger than steel, yet flexible, and a significantly better...
The world's highest gain high power laser amplifier - by many orders of magnitude - has been developed in research led at the University of Strathclyde.
The researchers demonstrated the feasibility of using plasma to amplify short laser pulses of picojoule-level energy up to 100 millijoules, which is a 'gain'...
Staphylococcus aureus is a feared pathogen (MRSA, multi-resistant S. aureus) due to frequent resistances against many antibiotics, especially in hospital infections. Researchers at the Paul-Ehrlich-Institut have identified immunological processes that prevent a successful immune response directed against the pathogenic agent. The delivery of bacterial proteins with RNA adjuvant or messenger RNA (mRNA) into immune cells allows the re-direction of the immune response towards an active defense against S. aureus. This could be of significant importance for the development of an effective vaccine. PLOS Pathogens has published these research results online on 25 May 2017.
Staphylococcus aureus (S. aureus) is a bacterium that colonizes by far more than half of the skin and the mucosa of adults, usually without causing infections....
Physicists from the University of Würzburg are capable of generating identical looking single light particles at the push of a button. Two new studies now demonstrate the potential this method holds.
The quantum computer has fuelled the imagination of scientists for decades: It is based on fundamentally different phenomena than a conventional computer....
An international team of physicists has monitored the scattering behaviour of electrons in a non-conducting material in real-time. Their insights could be beneficial for radiotherapy.
We can refer to electrons in non-conducting materials as ‘sluggish’. Typically, they remain fixed in a location, deep inside an atomic composite. It is hence...
24.05.2017 | Event News
23.05.2017 | Event News
22.05.2017 | Event News
30.05.2017 | Life Sciences
30.05.2017 | Power and Electrical Engineering
29.05.2017 | Earth Sciences