A quantitative pupillary light reflex <13% at 48 hours had 100% specificity and positive predictive value for poor recovery (0% false-positive rate), regardless of whether patients underwent therapeutic hypothermia.
The pupillometer uses an infrared camera to register precise measurements of pupil size and reactivity within seconds. This study's objective was to test whether automated quantitative pupillary light reflex (PLR) can be used to prognosticate coma recovery after cardiac arrest. The authors examined a prospective cohort of 103 comatose adult patients who were unconscious 48 hours after cardiac arrest. Clinical examination and electroencephalography (EEG), somatosensory evoked potentials (SSEP), and serum neuron-specific enolase tests were performed in parallel, as part of standard multimodal assessment. Score on the Cerebral Performance Categories at 1 year was the outcome endpoint.
At 48 hours, a quantitative PLR <13% had 100% specificity an…