Title: Predicting Neurologic Outcome in the Era of TTM<br/>Author: Michael Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
<u><strong>Predicting Neurologic Outcome in Patients Treated with TTM</strong></u></p>
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Whether you target 36<sup>o</sup>C or 33<sup>o</sup>C, targeted temperature management (TTM) improves survival and long-term neurologic oucome in survivors of out-of-hospital cardiac arrest.</li>
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TTM, however, can affect the accuracy and timing of commonly used tests to predict poor neurologic outcome.</li>
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Golan, et al just published a meta-analysis evaluating the accuracy of select diagnostic tests to predict outcome in patients treated with TTM.
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20 studies (1,845 patients)</li>
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Most accurate tests to predict poor neurologic outcome were:
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<strong>Bilaterally absent pupillary reflex </strong>(LR 10.45)</li>
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<strong>Bilaterally absent somatosensory-evoked potentials</strong> (LR 12.79)</li>
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Specificity of tests improved when testing was <strong>delayed > 72 hours</strong></li>
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Other commonly used tests (i.e., corneal reflexes, GCS motor score, unfavorable EEG readings) had higher false positive rates and lower LRs</li>
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<fieldset><legend>References</legend>
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Golan E, et al. Predicting neurologic outcome after targeted temperature management for cardiac arrest: Systematic review and meta-analysis. <em>Crit Care Med</em> 2014; 42:1919-30.</p>
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