How to prognosticate after cardiac arrest?
The neurologic examination is the best way to prognosticate outcome in comatose survivors of cardiac arrest.
The prognosis is invariably poor in comatose patients with absent pupillary or corneal reflexes or absent or extensor motor responses 3 days after cardiac arrest.
The best possible outcome for these patients after hospital discharge would be vegetative state or only fragmentary response to external stimuli.
These recommendations were based on data prior to the availability of induced hypothermia or TTM protocols.
Even though there are no new data to guide prognostication with the advent of these protocols, the general consensus is to determine prognosis 72 hours after rewarming has been achieved.
