Estimating the likelihood of recovery of cognitive function in the acutely comatose patient is one of the most difficult challenges facing neurologists and critical care physicians. Coma, defined as a state of unarousable unconsciousness, is most commonly caused by traumatic brain injury and anoxia following cardiopulmonary arrest. Patient outcome after severe brain injury is highly variable (Y...

BACKGROUND AND PURPOSE The prognosis of comatose survivors is determined by clinical examination. Early laboratory indicators of poor prognosis (such as evoked potentials) have low sensitivity. The role of MR imaging as a confirmatory study was investigated. METHODS We studied fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted (DW) imaging in 10 patients comatose after cardiac...

EEGs and somatosensory evoked responses from the brachial plexus, neck and scalp were recorded in seven comatose patients on continuous thiopentone infusion. Although pathological in five of the patients, the evoked responses were present in all. Additional amounts of thiopentone producing a full suppression of all spontaneous EEG activity had no effects either on the configuration of the evoke...

the relation between serum osmolality, glucose, sodium, bicarbonate, arterial ph, bun and level of consciousness was studied in 189 patients with diabetic ketoacidosis (dka). there was much overlap between all laboratory values among various groups, even when there was a statistically significant difference. to find a better predictor, we defined a new factor as serum osmolality/arterial ph. th...

The EEG changes, with associated cardiorespiratory phenomena and, where possible, postmortem findings, are described in six patients in coma, with some reference to other similar cases. Spontaneously occurring periodic changes were observed at varying intervals between 20 s and 4 min but most commonly at 1/2-2 min. These involved simultaneous cardiorespiratory, EEG, and somatic motor phenomena ...

Since the first report addressing quantification of cerebral blood flow (CBF), concomitant assessment of cerebral oxygen consumption was also carried out. Over the years, however, some investigators have emphatically and mistakenly addressed cerebral ischemia in comatose patients, on the basis of CBF measurements alone. In contrast, we have repeatedly reported that ischemia in these patients mu...

OBJECTIVE There is growing evidence that therapeutic hypothermia and other post-resuscitation care improves outcomes in out-of-hospital cardiac arrest (OHCA). Thus, transporting patients with return of spontaneous circulation (ROSC) to specialized facilities may increase survival rates. However, it is unknown whether prolonging transport to reach a designated facility would be detrimental. ME...

BACKGROUND Several lines of evidence suggest that early sensory stimulation and regular family visiting programs are potential nursing interventions to improve the outcomes of head injured comatose patients. However, little is known about the impacts of family involvement in providing sensory stimulation. OBJECTIVES To determine the effects of a sensory stimulation program conducted by nurses...