About the prognosis of patients with anoxic–ischemic encephalopathy, which of the following is incorrect?
A. The absence of a pupillary reaction to light suggests a poor prognosis but has unclear specificity when assessed early after a cardiac arrest, but if pupillary reactions are still absent at day 3 after cardiac arrest, the outcomes are poor.
B. Motor response to noxious stimuli that was no better than extensor posturing (i.e., a decerebrate response or no response) at 72 hours was associated with no false positives for a poor outcome, even if hypothermia is used.
msec after electrical stimulation of the median nerve at the wrist), has emerged as the most accurate predictor of a poor outcome in patients with anoxic–ischemic encephalopathy.
Answer: B
A small study of 37 initially comatose patients who underwent hypothermia showed recovery of awareness (on day 6) in 2 of 14 patients who had a motor response that was no better than extensor posturing on day 3. Therefore, caution is warranted in relying on the motor response alone before day 6 or possibly even later for patients who have received hypothermia therapy.