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• W4320731421 endingPage "101033" @default.
• W4320731421 startingPage "101033" @default.
• W4320731421 abstract "The development of status myoclonus (SM) in a postcardiac arrest patient has historically been thought of as indicative of not only a poor neurologic outcome but of neurologic devastation. In many instances, this may lead clinicians to initiate conversations about withdrawal of life sustaining therapies (WLST) regardless of the time from return of spontaneous circulation (ROSC). Recent studies showing a percentage of patients may make a good recovery has called into question whether a self-fulfilling prophecy has developed where the concern for a poor neurologic outcome leads clinicians to prematurely discuss WLST. The issue is only further complicated by changing terminology, lack of neuro-axis localization, and limited data regarding association with electroencephalogram (EEG) characteristics, all of which could aid in the understanding of the severity of neurologic injury associated with SM. Here we review the initial literature reporting SM as indicative of poor neurologic outcome, the studies that call this into question, the various definitions of SM and related terms as well as data regarding association with EEG backgrounds. We propose that improved prognostication on outcomes results from combining the presence of SM with other clinical variables (eg EEG patterns, MRI findings, and clinical exam). We discuss the ethical implications of using SM as a prognostic tool and its impact on decisions about life-sustaining care in children following cardiac arrest. We advocate for prognostication efforts to be delayed for at least 72 hours following ROSC and thus to treat SM in those early hours and days." @default.
• W4320731421 created "2023-02-15" @default.
• W4320731421 creator A5026527362 @default.
• W4320731421 creator A5082041887 @default.
• W4320731421 date "2023-04-01" @default.
• W4320731421 modified "2023-10-16" @default.
• W4320731421 title "To Treat or Not to Treat: Ethics of Management of Refractory Status Myoclonus Following Pediatric Anoxic Brain Injury" @default.
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• W4320731421 doi "https://doi.org/10.1016/j.spen.2023.101033" @default.
• W4320731421 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/37003631" @default.
• W4320731421 hasPublicationYear "2023" @default.
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