Which of the following indicators is most strongly correlated with a poor neurological outcome in the setting of anoxic ischemic encephalopathy after a cardiac arrest:
a) Total arrest time
b) Absent corneal reflexes at 72 hours after cardiopulmonary resuscitation
c) Elevated intracranial pressure
d) Absent oculocephalic reflexes at 72 hours after the arrest
The correct answer: B
Absent coronary reflexes 72 hours after CPR is one of the most sensitive indicators of poor neurological outcome. Absent oculocephalic reflexes at 72 hours does predict poor outcome, but is not as specific as absent corneal reflexes. Elevated intracranial pressure, total arrest time, duration of CPR, geographic location of arrest, elevated body temperature and concurrent respiratory failure are not strongly predictive of outcome.
FAST FACTS AND CONCEPTS #234: Prognosis of anoxic-ischemic Encephalopathy.