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Prognosis in anoxic and traumatic coma

J Attia1, D J Cook

  • 1Department of Medicine, McMaster University, Hamilton, Ontario, Canada.

Critical Care Clinics
|August 13, 1998
PubMed
Summary
This summary is machine-generated.

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Prognostic factors for coma are reviewed. For anoxic coma, lack of brainstem reflexes by day three accurately predicts poor outcomes, aided by EEG and evoked potentials.

Area of Science:

  • Neurology
  • Critical Care Medicine

Background:

  • Coma following hypoxic-anoxic injury or traumatic brain injury presents significant prognostic challenges.
  • Accurate prediction of outcomes is crucial for patient management and resource allocation.

Purpose of the Study:

  • To systematically review prognostic factors in patients with coma due to hypoxia/anoxia and traumatic head injury.
  • To evaluate the utility of clinical examination, electroencephalogram (EEG), and evoked potentials in predicting outcomes.

Main Methods:

  • Systematic review of existing literature.
  • Analysis of prognostic indicators including clinical signs, EEG, and evoked potentials.

Main Results:

  • In anoxic coma, absent brainstem reflexes by day three strongly indicate a poor prognosis.

Related Experiment Videos

  • Electroencephalogram and evoked potentials identify additional patients with poor prognosis in anoxic coma.
  • Clinical examination is less reliable for traumatic coma; evoked potentials within the first week identify about half of poor prognosis cases, with EEG offering limited additional value.

    • Conclusions:

    • Early bedside assessment of brainstem reflexes is highly effective for anoxic coma prognosis.
    • Neurophysiological tests like EEG and evoked potentials provide supplementary prognostic information, particularly in anoxic coma.
    • Prognostic assessment in traumatic coma remains challenging, with evoked potentials offering moderate predictive value.