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Osteosynthesis and Trauma Care 2005; 13(3): 137-142
DOI: 10.1055/s-2005-836328
Original Article

© Georg Thieme Verlag Stuttgart · New York

Value of Somatosensory Evoked Potentials of Short Latency in Intubated and Mechanically Ventilated Patients with Craniocerebral Trauma

E. Maurer1 , P. Milewski1 , C. Ulrich2
  • 1Department of Anesthesiology and Critical Care Medicine, Klinik am Eichert, Göppingen, Germany
  • 2Department of Traumatology, Klinik am Eichert, Göppingen, Germany
Further Information

Publication History

Publication Date:
23 August 2005 (online)

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Abstract

The objective of this study was to evaluate the prognostic value of somatosensory evoked potentials of short latency (SSEP) in patients with brain injury. Eighty-five patients who had been intubated and mechanically ventilated were investigated retrospectively. The Glasgow Coma Scale (GCS), determined by the emergency doctor at the scene of the accident, the SSEP score and the outcome of the patient were compared. There was no correlation between the GCS score and the patients's outcome. This is probably due to the too-brief interval between accident and evaluation of the GCS, so that awakening of the patient a short time after the accident is not reflected by the GCS. However, there was a significant correlation between the SSEP score obtained during the first examination after the accident and the outcome (p < 0.001). SSEP did not give rise to any false pessimistic prognoses. All patients without cortical responses either in one hemisphere or in both hemispheres remained in a coma vigile or died from their brain injuries. If the SSEP were normal or slightly pathologic, there were false optimistic prognoses in 9 % of the patients. These patients died because of their brain injury. Mild disabilities that are irrelevant to daily life were found in 84 % of the patients who initially had completely normal cortical responses. If the central conduction time over both hemispheres was pathologically extended, then only 67 % of the patients were not or only slightly disabled. If repetitive examinations were taken into account, all patients having cortical responses over both hemispheres at all times awoke from coma. Reliable prognosis based on SSEP is possible when clinical examination of the patient is limited due to sedating drugs. Repetitive examinations can be used to monitor the progress of recovery and to correct false optimistic prognoses. This is a bedside method that is both time and cost-saving.

Key words

outcome prediction - brain injury - somatosensory evoked potentials - Glasgow Coma Scale - GCS - SSEP

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Dr. E. Maurer

Anästhesie und operative Intensivmedizin · Kreiskrankenhaus Sigmaringen

Hohenzollernstr. 40

72488 Sigmaringen

Germany

Phone: 49/75 71/10 00

Email: ekhard.maurer@gmx.de

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