Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “COMA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,711 records · Page 95Linked to original sources
PubMed2006

Establishing a prognosis for functional outcome during coma recovery.

PRIMARY OBJECTIVE: One of the most challenging tasks for clinicians caring for survivors of severe brain injury (BI) is establishing a prognosis, for long-term functional outcome, while the patient is unconscious. The objective of this article is to report findings regarding the prediction of functional outcomes 1-year after severe BI using data available when the patient is unconscious. RESEARCH DESIGN: Longitudinal prognostication study. METHODS AND PROCEDURES: Persons unconscious after severe BI who present to inpatient (IP) rehabilitation hospitals in the Midwestern US are enrolled in an ongoing study. Each subject is followed for 1-year and the final outcome interview includes approximately 70 questions; 32 of these questions are from the Craig Handicap Assessment and Reporting Technique (CHART). A sample of 63 persons was abstracted from the study database to examine the predictability of 42 independent variables and 16 dichotomous outcomes. MAIN OUTCOMES AND RESULTS: Twelve of the 16 dichotomous outcomes were found to be significantly predictable (p < 0.05). These involve activity, participation, environment and quality of life outcomes. Ten predictors were found to be significant (p < 0.05): aetiology (Closed Head Injury vs. Other BI), presence of urinary tract infection (UTI), seizure, hypertension during IP rehabilitation, veteran benefit eligibility, health insurance, marital status at injury, whether or not recovery of consciousness occurred within 1 year, the number of days between injury and admission to acute rehabilitation and the average length of IP rehabilitation stay. Eight of the 10 variables are available early after injury or when the patient is unconscious.

Activities of Daily Living↗
PubMed2000

Prediction of poor outcome in anoxic-ischemic coma.

Most patients who are comatose a few hours after a period of global cerebral ischemia have a poor prognosis. In a series of studies selected with strict criteria for study design, the median prevalence of death or survival in a vegetative state was 78% (range, 56-90%) (Zandbergen et al., 1998). Most nonsurvivors die within the first weeks, not from brain damage, but from cardiac or pulmonary complications. Uncertainty about treatment and nontreatment decisions is therefore most critical during this period. To reduce this uncertainty among caregivers, and the related anxiety among family members, early identification of patients with such a poor prognosis is desirable.

Coma↗
PubMed1991

Continuous automated monitoring of somatosensory evoked potentials in posttraumatic coma.

Using a microcomputer system, 36 patients were continuously monitored with somatosensory evoked potentials (SSEPs) following closed head injury. The mean duration of monitoring was five days. The patients' GCS scores at the start of monitoring ranged from 3-10. Mortality was 44%. Of 14 patients who had initial absence of SSEP activity after the N20 wave or lost this activity during the period of monitoring, 12 died and two remained vegetative. Eighteen of 22 patients who had preservation or enhancement of this activity had a functional survival (3-month outcomes, p less than 0.001). The best outcomes were observed in the patients with the greatest number of peaks and highest amplitudes in the SSEPs, often in spite of increased intracranial pressure (ICP). The management of three patients was altered as a result of SSEP monitoring. We conclude that continuous monitoring of SSEPs is a useful adjunct in the management of comatose head-injured patients.

Adolescent↗
PubMed2006

Brainstem anaesthesia after retrobulbar block: a rare cause of coma presenting to the emergency department.

Local anaesthesia, in particular retrobulbar block, is commonly used to perform cataract surgery. Known complications of retrobulbar block include cranial nerve palsies, seizures and cardiorespiratory arrest. We report a case of brainstem anaesthesia causing apnoea and loss of consciousness in a man who received retrobulbar block. The likely mechanism is inadvertent dural puncture of the optic nerve sheath and local anaesthetic injection into the cerebrospinal fluid space. As in this case, the literature reports a short-lived period of anaesthesia with usually no long-term sequelae. Although rare, it is a life-threatening complication if the patient is not appropriately resuscitated. This case highlights the need for trained personnel, with suitable monitoring and adequate resuscitation facilities in order to perform this technique.

Aged↗
PubMed1953

Myxoedema coma.

Explore the source record for details and available documents.

Coma↗