مورد إلكتروني
Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: an international prospective multicenter double-blinded study
العنوان: | Quantitative versus standard pupillary light reflex for early prognostication in comatose cardiac arrest patients: an international prospective multicenter double-blinded study |
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المؤلفون: | Oddo, M, Sandroni, C, Citerio, G, Miroz, J, Horn, J, Rundgren, M, Cariou, A, Payen, J, Storm, C, Stammet, P, Taccone, F, Oddo, Mauro, Sandroni, Claudio, Citerio, Giuseppe, Miroz, John-Paul, Horn, Janneke, Rundgren, Malin, Cariou, Alain, Payen, Jean-François, Storm, Christian, Stammet, Pascal, Taccone, Fabio Silvio |
بيانات النشر: | Springer Verlag 2018 |
نوع الوثيقة: | Electronic Resource |
مستخلص: | Purpose: To assess the ability of quantitative pupillometry [using the Neurological Pupil index (NPi)] to predict an unfavorable neurological outcome after cardiac arrest (CA). Methods: We performed a prospective international multicenter study (10 centers) in adult comatose CA patients. Quantitative NPi and standard manual pupillary light reflex (sPLR)—blinded to clinicians and outcome assessors—were recorded in parallel from day 1 to 3 after CA. Primary study endpoint was to compare the value of NPi versus sPLR to predict 3-month Cerebral Performance Category (CPC), dichotomized as favorable (CPC 1–2: full recovery or moderate disability) versus unfavorable outcome (CPC 3–5: severe disability, vegetative state, or death). Results: At any time between day 1 and 3, an NPi ≤ 2 (n = 456 patients) had a 51% (95% CI 49–53) negative predictive value and a 100% positive predictive value [PPV; 0% (0–2) false-positive rate], with a 100% (98–100) specificity and 32% (27–38) sensitivity for the prediction of unfavorable outcome. Compared with NPi, sPLR had significantly lower PPV and significantly lower specificity (p < 0.001 at day 1 and 2; p = 0.06 at day 3). The combination of NPi ≤ 2 with bilaterally absent somatosensory evoked potentials (SSEP; n = 188 patients) provided higher sensitivity [58% (49–67) vs. 48% (39–57) for SSEP alone], with comparable specificity [100% (94–100)]. Conclusions: Quantitative NPi had excellent ability to predict an unfavorable outcome from day 1 after CA, with no false positives, and significantly higher specificity than standard manual pupillary examination. The addition of NPi to SSEP increased sensitivity of outcome prediction, while maintaining 100% specificity |
مصطلحات الفهرس: | Pupillometry, Pupillary reactivity, Neurological pupil index, Outcome, Cardiac arrest, Prognostication, info:eu-repo/semantics/article |
URL: | info:eu-repo/semantics/altIdentifier/pmid/30478620 info:eu-repo/semantics/altIdentifier/wos/WOS:000452162900008 volume:44 issue:12 firstpage:2102 lastpage:2111 numberofpages:10 journal:INTENSIVE CARE MEDICINE |
الإتاحة: | Open access content. Open access content info:eu-repo/semantics/closedAccess |
ملاحظة: | English |
أرقام أخرى: | ITBAO oai:boa.unimib.it:10281/211608 10.1007/s00134-018-5448-6 info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85057524057 1308926585 |
المصدر المساهم: | BICOCCA OPEN ARCH From OAIster®, provided by the OCLC Cooperative. |
رقم الأكسشن: | edsoai.on1308926585 |
قاعدة البيانات: | OAIster |
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