Maayke Hunfeld

59 Review neuromonitoring Results Morta- lity (%) Limitations Grade -Strong significant correlation between abnormalities (cortical or basal ganglia T2 or presence of edema occipital or generalized) at day 3-4 and outcome (P<0.001). T2 changes did not reverse and sign correlated with poor outcome -Best correlation with outcome was MRI day 3-4. PPV and NPV of abnormal MRI for a poor outcome 100% (T2 abnormalities cortex or BG, brain stem infarction or generalized/occ edema) -Spectroscopy in good outcome normal, in vegetative outcome abnormal (3 out of 4 at first MRI and 1 out of 4 day 3), in death abnormal (10 out of 12 at first MRI and 2 at day 4) -A sign correlation between abnormal MR spectra and abnormal MRI on day 3-4 (P<0.0001) 55% -Retrospective -Only near drowning -Small cohort -Were clinicians blinded? -Crude and adult outcome scale -Timing outcome unclear -Wide age range 2B/C (unclear timing outcome) -N=16 with normal MRI all survived, N=6 had decrease in GOS score -T1/T2: Association betweenmultiple brain lobes affected and worse outcome (P<0.01) -Occipital lobe and lenticular nucleus lesions on T1 and lesions in lenticular and caudate nucleus on T2 associated with (unfavorable outcome (P<0.05) -DWI/ADC: Lesions inmultiple brain lobes associated with poor outcome (P=0.02) -No effect therapeutic hypothermia Infrequent follow-upMRI scan showed evolution of lesions 18% -Retrospective -Small cohort -MRI only performed when clinically indicated -Crude and unusual short term outcome scale -Hypothermia not standard -Possible secondary insults like fever or hypotension not analyzed -Timing MRI different 2B 2