Maayke Hunfeld

45 Review neuromonitoring Neurological examination Timing Results Limitations EBM Grade At admission: GCS, pupillary reactivity and spontaneous respiratory activity 24 hours after admission: GCS, pupillary reactivity and spontaneous respiratory activity Admission: GCS, pupillary reactivity and spontaneous respiratory activity were not predictive for outcome. 24 hrs: In 42 children with impaired consciousness: GCS was lower in unfavourable group (5 ± 2 vs 10 ± 3; P<0.0001). In 42 children with impaired consciousness: GCS< 5, absence of spontaneous respiratory activity and PR have a 100% PPV for poor outcome -Heterogeneous population (no subgroup analysis possible for CA) Crude outcome 2B Serial motor and pupillary responses in the first 9 days -In HIE patients: Sensitivity and specificity for absent motor response and poor outcome is 93%/50% Sensitivity and specificity for absent pupillary responses is 47%/100% 7 patients with absent motor response had good outcome (sedatives) -Missing data -HIE included, unclear if and how many CA patients are included. -Clinician not blinded for findings motor and pupillary responses -Multiple patients used sedatives and or analgesics -Timing of motor response and pupillary responses are unclear -Crude outcome 2B/C Pupillary responses Motor responses Assessments: final hour of HT, 1 hour after HT, 1 hour after NT, 1 day after NT, 3 days after NT Absent motor and pupil responses after normothermia predicted poor outcome (PPV 100%) Paralytic drugs lowered the predictive value -Short term and crude outcome -Clinician not blinded for findings motor responses and pupillary responses 2B/C 2