Figure 5
From: How to assess prognosis after cardiac arrest and therapeutic hypothermia
Multimodal prognostication of coma after cardiac arrest and therapeutic hypothermia. Summary of the suggested timing after cardiac arrest of all available tools that are used to predict poor outcome or neurological recovery from coma. This algorithm suggests that poor prognosis or neurological recovery should be considered when specific findings are present but this does not necessarily mean that withdrawal of care should be initiated, because this approach has not been validated. Dashed lines, lack of strong evidence to support the suggestion. High biomarker levels did not relate to a specific cutoff value because of several limitations affecting their measurements and accuracy (see text). BS, burst suppression; BSR, brainstem reflexes; EEG, electroencephalogram; GPED, generalized periodic epileptiform discharge; M1–2, absent motor response or posturing; MRI, magnetic resonance imaging; N20, cortical responses to somatosensory evoked potentials; NSE, neuron-specific enolase; SM, status myoclonus; SSEP, somatosensory evoked potential; uNCSE, unreactive nonconvulsive seizures; uSE, unreactive status epilepticus.