Immediate prediction of recovery of consciousness after cardiac arrest

Objective: Short-latency somatosensory evoked potential (SSEP) monitoring h as been reported to be useful in predicting neurological outcome in patient s with cardiac arrest and hypoxic-ischemic encephalopathy. To obtain the im mediate data of SSEP and evaluate the relationship between the presence of cortical activity and the recovery of consciousness, SSEP was recorded imme diately after return of spontaneous circulation. Design and setting: Prospective observational study in an intensive care un it of a university general hospital. Patients: The study included 30 patients resuscitated from out-of-hospital cardiac arrest. Interventions. Basic and advanced cardiac life support, and intensive care. Measurements and results. SSEP were recorded between 40 and 170 min (median 65) after spontaneous circulation returned. In the initial study all 30 pa tients showed the Erb's point potential and the N11-13 component, while onl y 12 (40%) showed cortical activity. Patients were assessed neurologically for recovery of consciousness until I month after cardiac arrest. Of 12 the se patients 8 recovered consciousness within 10 days, while all patients wi thout cortical activity died without opening, their eyes. Conclusion: Even immediately following resuscitation, absence of cortical a ctivity in SSEP indicates unlikelihood of recovering consciousness, while t he preservation of such activity suggests that consciousness is improved. T he result promises further accumulation of patients to validate the predict ive ability of SSEP in managing postresuscitated patients.