Feasibility and diagnostic accuracy of early electrophysiological recordings for ICU-acquired weakness: an observational cohort study.

Background: An early diagnosis of ICU-acquired weakness (ICU-AW) is difficult because disorders of consciousness frequently preclude muscle strength assessment. In this study, we investigated feasibility and accuracy of electrophysiological recordings to diagnose ICU-AW early in non-awake critically ill patients.

Methods: Newly admitted patients, mechanically ventilated ≥2 days and unreactive to verbal stimuli, were included in this study.

Hypothermia after CPR prolongs conduction times of somatosensory evoked potentials.

Background: To investigate the effect of mild hypothermia on conduction times and amplitudes of median nerve somatosensory evoked potentials (SEP) in patients after cardiopulmonary resuscitation (CPR).

Methods: Patients treated with hypothermia after CPR who underwent SEP recording during hypothermia and after rewarming were selected from a prospectively collected database. Latencies and amplitudes of N9 (peripheral conduction time, PCT), N13, and N20 were measured.

Acute posthypoxic myoclonus after cardiopulmonary resuscitation.

Background: Acute posthypoxic myoclonus (PHM) can occur in patients admitted after cardiopulmonary resuscitation (CPR) and is considered to have a poor prognosis. The origin can be cortical and/or subcortical and this might be an important determinant for treatment options and prognosis. The aim of the study was to investigate whether acute PHM originates from cortical or subcortical structures, using somatosensory evoked potential (SEP) and electroencephalogram (EEG).

The influence of rewarming after therapeutic hypothermia on outcome after cardiac arrest.

Introduction: Treatment with hypothermia has been shown to improve outcome after cardiac arrest (CA). Current consensus is to rewarm at 0.25-0.

Prognosis of coma after therapeutic hypothermia: a prospective cohort study.

Objective: This study was designed to establish the reliability of neurologic examination, neuron-specific enolase (NSE), and median nerve somatosensory-evoked potentials (SEPs) to predict poor outcome in patients treated with mild hypothermia after cardiopulmonary resuscitation (CPR).

Methods: This multicenter prospective cohort study included adult comatose patients admitted to the intensive care unit (ICU) after CPR and treated with hypothermia (32-34°C). False-positive rates (FPRs 1 - specificity) with their 95% confidence intervals (CIs) were calculated for pupillary light responses, corneal reflexes, and motor scores 72 hours after CPR; NSE levels at admission, 12 hours after reaching target temperature, and 36 hours and 48 hours after collapse; and SEPs during hypothermia and after rewarming.

Predictive value of neurological examination for early cortical responses to somatosensory evoked potentials in patients with postanoxic coma.

Bilateral absence of cortical N20 responses of median nerve somatosensory evoked potentials (SEP) predicts poor neurological outcome in postanoxic coma after cardiopulmonary resuscitation (CPR). Although SEP is easy to perform and available in most hospitals, it is worthwhile to know how neurological signs are associated with SEP results. The aim of this study was to investigate whether specific clinical neurological signs are associated with either an absent or a present median nerve SEP in patients after CPR.

Induced hypothermia and determination of neurological outcome after CPR in ICUs in the Netherlands: results of a survey.

Introduction: Induction of hypothermia is generally accepted to increase survival of out-of-hospital cardiac arrest, but lack of initiation of this treatment has been frequently reported. When patients remain in coma after treatment with hypothermia, determination of prognosis is difficult. Furthermore, little is known about the methods used in clinical practice to predict outcome after cardiopulmonary resuscitation (CPR).