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A major miss in prognostication after cardiac arrest: Burst suppression and brain healing.

TitleA major miss in prognostication after cardiac arrest: Burst suppression and brain healing.
Publication TypeJournal Article
Year of Publication2017
AuthorsBecker, Danielle A., Schiff Nicholas D., Becker Lance B., Holmes Manisha G., Fins Joseph J., Horowitz James M., and Devinsky Orrin
JournalEpilepsy Behav Case Rep
Volume7
Pagination1-5
Date Published2017
ISSN2213-3232
Abstract

We report a case with therapeutic hypothermia after cardiac arrest where meaningful recovery far exceeded anticipated negative endpoints following cardiac arrest with loss of brainstem reflexes and subsequent status epilepticus. This man survived and recovered after an out-of-hospital cardiac arrest followed by a 6-week coma with absent motor responses and 5 weeks of burst suppression. Standard criteria suggested no chance of recovery. His recovery may relate to the effect of burst-suppression on EEG to rescue neurons near neuronal cell death. Further research to understand the mechanisms of therapeutic hypothermia and late restoration of neuronal functional capacity may improve prediction and aid end-of-life decisions after cardiac arrest.

DOI10.1016/j.ebcr.2016.09.004
Alternate JournalEpilepsy Behav Case Rep
PubMed ID28053858
PubMed Central IDPMC5198796

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