23, 28, 30
The quantitative basis for saying that the circuit preserves specificity but degrades discrimination - so indeterminate assessments should be expected more often on ECMO, and indeterminacy is the expected result rather than a failure of the workup.
Patients without a circuit
[VERIFICATION REQUIRED] - DOI/PMID not confirmed
Standard multimodal prognostic items - pupillary reflex, electroencephalographic background and reactivity, evoked potentials, myoclonus, neuron-specific enolase
Only 50 ECMO patients; the discrimination difference is not statistically significant and the authors call for prospective assessment in a larger cohort. Structured abstract only. [VERIFICATION REQUIRED]
Poor functional outcome 74% with ECMO against 59% without (P = 0.040). Specificity of each item 92-100% in both groups; specificity of two or more items 100% with ECMO and 99.3% without. Neuron-specific enolase was significantly higher in ECMO patients (P below 0.001). Discrimination of the combination fell from an area under the curve of 0.822 without a circuit to 0.681 with one (P = 0.134).
397 post-arrest patients without ECMO against 50 with venoarterial ECMO for refractory arrest