A structured approach to neurologic prognostication in clinical cardiac arrest trials

Table 1 Findings allowing for discontinuation of life support in the TTM-trial

	Time period	Findings
1	Any time-point	Brain death.
2	<24 h from ROSC	Early myoclonus status^# and bilateral absence of N20 peak on SSEP after rewarming.
3	72 h after rewarming	GCS-M 1–2 and bilateral absence of N20 peak on SSEP performed 48–72 hours after rewarming, or later.
4	72 h after rewarming	A treatment refractory status epilepticus* and GCS-M 1–2.

# Generalized myoclonic seizures in face and extremities and continuous for a minimum of 30 min.
*Status epilepticus defined by EEG as sequences (>10 sec) of repetitive epileptiform discharges with an amplitude >50 μV and a medium frequency ≥1Hz, constituting >50% of a 30 minute period in a patient with or without clinical manifestations. Treatment refractory defined as unresponsive to treatment with propofol, midazolam or thiopental for at least 24 h in combination with at least one intravenous antiepileptic substance (including valproate and/or fos-Phenytoin) in adequate dose for at least 24 h. Free use of further antiepileptic substances and combinations at the discretion of the attending physician.

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