Adult survivors of severe cerebral hypoxia – case series survey and comparative analysis

Abstract

Over 16 years, Wilson [31] saw and assessed 567 patients, 18 (3.2%) had a primary diagnosis of cerebral hypoxia. The present patient survey includes all referrals for assessment, management/advice and neuropsychological rehabilitation to a part-time clinical neuropsychology service, who were seen by the first author over a five year period (October 1995(October -2000. Of the total patient sample (n = 168), 13 (7.7%) had incurred hypoxic damage from a variety of causes; [3] carbon monoxide poisoning (smoke inhalation), [3] cardiac arrest, [1] accidental alcohol and drug overdose, [1] near (partial) drowning, [1] near hanging (suffocation), [2] respiratory arrest following prolonged status epilepticus, [1] respiratory arrest following severe pneumonia and [1] following Addisonian crisis. The survey includes a sub-group of patients in vegetative and minimally responsive states on referral. Wilson [31] highlighted that considerable variation in cognitive functioning is likely to be observed depending on (a) nature or cause of the hypoxic insult and (b) the degree of anoxia/hypoxia experienced itself. The results of the present survey when compared with Wilson's earlier work provide a larger total data-set from which to draw conclusions and has implications for practitioners who see such patients and are involved in their multidisciplinary management and rehabilitation.

Responsiveness of Instruments to Assess Disorders of Consciousness: A Literature Review

“…Three of the five papers used statistical analysis to determine the significance of change and Cohen's d was calculated for three papers (Wilson, Coleman, & Pickard, 2008;Wilson, Elder, McCrudden, & Caldwell, 2009;Wilson, Harpur, Watson, & Morrow, 2003). Effect sizes were in excess of 0.8 for two of the studies (Wilson et al, 2008(Wilson et al, , 2009 with moderate effect sizes for a smaller sample of seven participants (Wilson et al, 2003). This same study by Wilson and colleagues (2003) compared improvement according to the GCS CRS-R used to measure changes from VS to MCS and emergence from MCS.…”

“…Emerged later group: WNSSP X = 8.0, df = 2, p = 0.018 SMART X = 6.86, df = 2, p = 0.032 NS for non-emerged group See the footnote to and RLAS with improvement on the WHIM. The WHIM indicated improvements in all seven cases whereas the GCS and RLAS indicated concurrent improvements in only four of the seven cases (Wilson et al, 2003). Very few articles measured change on the SSAM (n = 1) or DOCS (n = 2) ( Table 4).…”

Part 6. Pediatric advanced life support: 2015 Korean Guidelines for Cardiopulmonary Resuscitation

“…Amiodarone and lidocaine can be used in infants and children with VF and pulseless VT that does not respond to defibrilaltion [ 22 , 36 , 37 ]. Nevertheless, there is a significant possibility of adverse effect(s) in cases with a low cardiac output, abnormal hepatic function, or abnormal renal function [ 38 , 39 ].…”

Behavioural and Psychosocial Outcome Following Vegetative and Minimally Conscious States: Long-Term Follow-Up

“…None of the patients in the vegetative group improved significantly across the observation period. In contrast, Wilson, Harpur, Watson and Morrow (2003) reported improved scores on the Wessex Head Injury Matrix (WHIM) in both patients in MCS and VS secondary to hypoxic brain injury across serial assessments on average 2 years post injury, suggesting some improvement over the long term. Lammi, Smith, Tate and Taylor (2005) investigated the outcome of 18 people in the MCS (median length 56 days) following TBI, 2 to 5 years post injury.…”