Improved outcome prediction in unconscious cardiac arrest survivors with sensory evoked potentials compared with clinical assessment

Cortical Processing of Noxious Somatosensory Stimuli in the Persistent Vegetative State

“…It is unlikely that the administration of rocuronium bromide (a muscle relaxant that undergoes no detectable metabolism and does not pass the blood-brain barrier) (Khuenl-Brady and Sparr, 1996) could account for the observed differences in neural activation with healthy volunteers. The stimulation intensities used were below those commonly employed when SEPs are recorded in unconscious patients at the intensive care unit (e.g., Madl et al, 2000). PVS represents such an immense affective, social, and economic problem (Beresford, 1997) that it warrants further research to better understand its underlying cerebral dysfunction.…”

Somatosensory and brainstem auditory evoked potentials in cardiac arrest patients treated with hypothermia*

“…Madl et al have previously shown that in normothermic cardiac arrest patients, a latency Ͼ130 msec to cortical evoked potential N70 peak or absent N70 peaks predict poor outcome with a specificity of 97% and sensitivity of 94%. They also found that the N70 longlatency sensory evoked potential was more accurate in predicting individual outcome than was a panel of three experienced emergency physicians reviewing clinical data 24 hrs after cardiac arrest (23). Because of the slowing of neural transmission with hypothermia, the N70 cut-off values determined for normothermic patients cannot be applied to hypothermic patients.…”

Perception of pain in the minimally conscious state with PET activation: an observational study

“…10 The stimulation intensities used in non-communicative patients were lower than those used routinely when somatosensory evoked potentials are recorded at an intensive care unit. 15 The study was approved by the ethics committee of the Faculty of Medicine of the University of Liège and done in accordance with the Declaration of Helsinki 16 and the International Association for the Study of Pain (IASP) Ethical Guidelines for Pain Research in Humans. 17 Changes in regional cerebral blood fl ow were measured with ¹⁵O-radiolabelled water PET, as described elsewhere.…”