J Korean Soc Emerg Med.  2004 Dec;15(6):456-462.

Prediction of Poor Outcome in Comatose Survivors after Cardiopulmonary Resuscitation with Somatosensory Evoked Potentials and Proton Magnetic Resonance Spectroscopy

• Choi SP
• Oh IY
• Kim YM
• Park KN
• Jeong SK
• Ann GJ
• Sung CH
• Lee WJ
• Kim SK

Abstract

PURPOSE
The study was conducted to examine the usefulness of somatosensory evoked potentials (SEP) and proton magnetic resonance spectroscopy (1H-MRS) in predicting poor outcomes for comatose survivors after cardiopulmonary resuscitation.
METHODS
We investigated 36 patients who were comatose after cardiac arrest. Among them, 35 had short latency SEP, and 27 had 1H-MRS. Both tests were performed in 26 patients. To estimate the cerebral outcome, we used the cerebral performance category (CPC) to classify the outcomes for our patients as good (CPC 1-2) or poor (CPC 3-5).
RESULTS
Of the 36 patients, 11(31%) presented with good outcomes (CPC 1-2). A bilaterally absent N20 peak (n=35) predicted poor outcomes with a sensitivity of 54.2% and a specificity of 100%. A lactate-positive resonance (n=27) predicted poor outcomes with a sensitivity of 78.9% and a specificity of 100%. Using a combination of a bilaterally absent N20 peak and a lactate-positive resonance (n=26) predicted poor outcomes with a sensitivity of 94.4% and a specificity of 100%.
CONCLUSION
The combination of a bilaterally absent N20 peak and a lactate-positive resonance is better than either alone in predicting poor outcomes in patients who are comatose after cardiac arrest.

Keyword

Cardiopulmonary resuscitation; Somatosensory evoked potential; Magnetic resonance spectroscopy

MeSH Terms

Cardiopulmonary Resuscitation*
Coma*
Evoked Potentials, Somatosensory*
Heart Arrest
Humans
Magnetic Resonance Spectroscopy*
Protons*
Sensitivity and Specificity
Survivors*
Protons