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Otoacoustic Emissions for Outcome Prediction in Postanoxic Brain Injury
Daniel Kondziella1, Anne Marie Jensen2, Thomas Hjuler2
1Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Frontiers in Neurology
|October 16, 2018
Summary
Otoacoustic emissions are not reliable for predicting outcomes in unresponsive cardiac arrest patients. While convenient, partially preserved otoacoustic emissions were found in some patients, limiting their prognostic value.
Area of Science:
- Neurology
- Otoacoustic Emissions
- Critical Care Medicine
Background:
- Unresponsive patients with postanoxic brain injury require non-invasive bedside prognostic tools.
- Otoacoustic emissions (OAEs) were investigated as potential outcome markers post-cardiac arrest.
- Existing prognostic methods for severe brain injury lack ease of use at the bedside.
Purpose of the Study:
- To evaluate the utility of otoacoustic emissions (OAEs) as prognostic markers in patients following cardiac arrest.
- To compare OAE measurements between cardiac arrest survivors with poor prognosis and control patients.
Main Methods:
- Distortion product otoacoustic emissions (DPOAE) and transient evoked otoacoustic emissions (TEOAE) were measured.
- Measurements were taken in 10 cardiac arrest patients with poor neurological prognosis.
- A control group of 10 myocardial infarction patients without loss of consciousness was included.
Main Results:
- Cardiac arrest patients with poor prognosis showed significantly lower rates of preserved DPOAE compared to controls (9.2% vs. 40.8%, p < 0.0001).
- Partially preserved DPOAE were observed in 4 of the 10 cardiac arrest patients.
- No significant difference in TEOAE was found between the groups.
Conclusions:
- Otoacoustic emissions are not currently reliable prognostic markers for cardiac arrest survivors.
- The presence of partially preserved OAEs in some non-responsive patients limits their definitive prognostic capability.
- Further research into decaying outer hair cell function may offer insights into evolving ischemic brain damage.
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