Prognosis in presumptive hypoxic-ischemic coma in nonneurologic trauma

Neuroimaging and Serologic Markers of Neurologic Injury after Cardiac Arrest

Determining prognosis in the setting of hypoxic-ischemic injury following cardiac arrest is difficult based solely on clinical parameters in the patient who is critically ill. The article discusses bio- chemical markers in the blood and in the cerebrospinal fluid that are evaluated for prognostic information, along with radiologic indicators of anoxic cerebral damage. It includes a recommended algorithm using a combination of serologic and radiologic markers of cerebral injury for assessing prognosis in the patient who is comatose following cardiac arrest.

Outcome of coma in children

Coma following a hypoxic-ischemic event is a serious condition and common reason for admission to the pediatric intensive care unit. Because coma has a high rate of mortality and morbidity in children, and the clinician may be unsure of the outcome very early in the course, it is important to have strategies to define prognosis. Although most studies have been conducted in adults, we review factors predicting outcome from coma of nontraumatic causes in infants and children. We consider the relation between physical findings, commonly accessible laboratory tools, and outcome, and comment on some newer techniques that may become more available for clinical purposes.