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https://www.msdmanuals.com/professional/neurologic-disorders/coma-and-impaired-consciousness/overview-of-coma-and-impaired-consciousness
Extensor posturing or no response elicited by painful stimuli 72 hours after cardiac arrest No response 20 milliseconds (N20) after stimulation of somatosensory evoked potential (SEP) Serum neuron-specific enolase level of > 33 mcg/L
https://tbi.vcu.edu/chat-with-pat/medical-issues/coma--the-vegetative-state/
Technically, an injury that results in a coma or a period of unconsciousness that lasts more than 24 hours can be classified as severe (versus mild). For more information on severe brain injury, coma, and outcome, please take a look at the FAQ’s on this Internet site and consult your state Brain Injury Association.
https://ccforum.biomedcentral.com/articles/10.1186/cc13696
In patients not treated with TH, a lack of motor response or extensor response to pain (Glasgow Coma Score – Motor Response (GCS-M) ≤2), bilateral lack of pupillary reflexes and bilateral lack of corneal reflexes at 72 hours after CA have all been regarded as reliable signs of a poor prognosis . Today, however, the clinical course of neurological recovery is obscured by sedation and muscle …
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357920/
In a small retrospective study with 37 comatose post-cardiac arrest patients treated with hypothermia, none of six patients without pupillary reflexes and none without corneal reflexes at 72 hours after the arrest recovered awareness ; however, a recent prospective study of 111 comatose patients after cardiac arrest treated with induced hypothermia found a false-positive rate of the absence of one or more …
https://emcrit.org/wp-content/uploads/2012/02/neuro-prognosis-post-arrest.pdf
72 hours after cardiac arrest ultimately regained consciousness and achieved a good outcome.17 Eleven of the patients in this study had a poor motor response at 72 hours and survived, and 4 patients achieved a good outcome. Overall, evidence suggests that an absent motor response at 72 hours post-arrest does not reliably predict poor prognosis
https://hospicefoundation.org/Hospice-Care/Signs-of-Approaching-Death
Caregivers, family, and physicians should always act as if the dying person is aware of what is going on and is able to hear and understand voices. In fact, hearing is one of the last senses to lapse before death. Often before death, people will lapse into a coma. A coma is a deep state of unconsciousness in which a person cannot be aroused.
https://www.mypcnow.org/fast-fact/prognosis-of-anoxic-ischemic-encephalopathy/
Absent pupillary light reflexes 24 hours after CPR, or 72 hours after CPR for those who initially had intact papillary light reflexes (3,6,7). Absent corneal reflexes 72 hours post-CPR (6,7). Short-latency Somatosensory Evoked Potentials (SSEP, an electrophysiologic study): bilateral absence of the N20 potentials on SSEP of the median nerve in AIE patients greater than 24 hours post-CPR (1,6,7,8).
https://derangedphysiology.com/main/required-reading/neurology-and-neurosurgery/Chapter%20412/approach-unconscious-patient-icu
Poor motor response after 72 hours (anything worse than withdrawal) Absent spontaneous eye movements after 24 hours Of course, these findings are all from studies which were done before the era of therapeutic hypothermia.
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