Survival in young children after drowning: brain evoked potentials as outcome predictors

Twenty young children between the ages of 4 and 103 months involved in drownings had brain evoked potential (EP) studies done shortly after the incident (median 2 days) to determine if auditory click and visual flash EP patterns were predictive of outcome. Results were examined in relation to good survival or non/poor (vegatative) level of survival. Results were also compared to selected clinical and laboratory data previously reported as predicting outcome. These preliminary findings indicate that if patients have evoked potential abnormality (EPA) scores greater than 2.7 there is little chance of survival. With EPA scores below 2.7 it was found that there is a good chance of survival. Cortical responses to auditory and visual stimulation were observed to be good predictors of outcome despite their inherent variability in young children and the presence of barbiturate coma. Brainstem responses to auditory stimulation alone were poor predictors. Previously reported clinical and laboratory predictors of outcome did not hold up except for muscle flaccidity which, when present, was associated with non/poor survival.