Prediction of outcome after hypoxic-ischemic encephalopathy: a prospective clinical and electrophysiologic study.
J Pediatr
; 141(1): 45-50, 2002 Jul.
Article
em En
| MEDLINE
| ID: mdl-12091850
OBJECTIVES: To evaluate and compare the predictive value of history, clinical examination, and biologic and electrophysiologic data regarding the prognosis of children with acute hypoxic-ischemic encephalopathy (HIE). STUDY DESIGN: Prospective cohort of 57 consecutive children who were mechanically ventilated for HIE throughout a 3-year period in a tertiary pediatric intensive care unit at a university hospital in France. RESULTS: At 24 hours after admission, 12 patients had died, 3 were awake and 42 showed impaired consciousness or were in a coma, of whom 38% had a favorable outcome. In this group, an initial cardiopulmonary resuscitation duration longer than 10 minutes and a Glasgow Coma Scale <5 at 24 hours after admission were associated with an unfavorable outcome (positive predictive value [PPV] 91%, 100%; sensitivity 50%, 54%). A discontinuous electroencephalogram (EEG), the presence of spikes or epileptiform discharges were associated with an unfavorable outcome (PPV 100% for the 2 criteria; sensitivity 27%, 54%). The bilateral absence of the N20 wave on short-latency sensory evoked potentials (SEPs) had a PPV for unfavorable outcome of 100% (sensitivity 63%). CONCLUSIONS: The clinical assessment combined with EEG and SEPs allow an early prediction of the prognosis of children with HIE.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Hipóxia-Isquemia Encefálica
/
Eletroencefalografia
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Potenciais Somatossensoriais Evocados
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Pediatr
Ano de publicação:
2002
Tipo de documento:
Article
País de afiliação:
França
País de publicação:
Estados Unidos