23, 24
The cleanest half of the prognostic literature, because no unit withdraws treatment on a favourable sign. Gives three findings to look for actively on ECMO - a continuous background, a falling enolase, and a good-amplitude N20 - and requires them to be written into the same note as the unfavourable ones.
Good neurological outcome
[VERIFICATION REQUIRED] - DOI/PMID not confirmed
Favourable multimodal predictors - enolase value and trajectory, electroencephalographic background, evoked potential amplitude
Single cohort, retrospective, no ECMO patients. Structured abstract only. [VERIFICATION REQUIRED]
Enolase under 17 µg/L at 24 hours gave a positive predictive value of 71% with 9% sensitivity; best cut-offs of 45.5, 51.5 and 41.5 µg/L gave predictive values of 64%, 80% and 83%. A falling trajectory between 24 and 72 hours gave a positive predictive value of 82% with 81% sensitivity. Benign background 72% and 94%; N20 amplitude above 0.85 µV 75% and 100%. The combination reached a positive predictive value of 96% with 76% sensitivity.
215 comatose adults after cardiac arrest