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EEG for good outcome prediction after cardiac arrest: A multicentre cohort study
S. Turella, J. Dankiewicz, N. Ben-Hamouda, KB. Nilsen, J. Düring, C. Endisch, M. Engstrøm, D. Flügel, N. Gaspard, AM. Grejs, M. Haenggi, S. Haffey, L. Imbach, B. Johnsen, D. Kemlink, C. Leithner, S. Legriel, H. Lindehammar, G. Mazzon, N. Nielsen,...
Jazyk angličtina Země Irsko
Typ dokumentu časopisecké články, multicentrická studie, pozorovací studie
- MeSH
- elektroencefalografie * metody MeSH
- kardiopulmonální resuscitace metody MeSH
- kóma etiologie patofyziologie diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- prospektivní studie MeSH
- senioři MeSH
- terapeutická hypotermie * metody MeSH
- zástava srdce mimo nemocnici * terapie patofyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
AIM: Assess the prognostic ability of a non-highly malignant and reactive EEG to predict good outcome after cardiac arrest (CA). METHODS: Prospective observational multicentre substudy of the "Targeted Hypothermia versus Targeted Normothermia after Out-of-hospital Cardiac Arrest Trial", also known as the TTM2-trial. Presence or absence of highly malignant EEG patterns and EEG reactivity to external stimuli were prospectively assessed and reported by the trial sites. Highly malignant patterns were defined as burst-suppression or suppression with or without superimposed periodic discharges. Multimodal prognostication was performed 96 h after CA. Good outcome at 6 months was defined as a modified Rankin Scale score of 0-3. RESULTS: 873 comatose patients at 59 sites had an EEG assessment during the hospital stay. Of these, 283 (32%) had good outcome. EEG was recorded at a median of 69 h (IQR 47-91) after CA. Absence of highly malignant EEG patterns was seen in 543 patients of whom 255 (29% of the cohort) had preserved EEG reactivity. A non-highly malignant and reactive EEG had 56% (CI 50-61) sensitivity and 83% (CI 80-86) specificity to predict good outcome. Presence of EEG reactivity contributed (p < 0.001) to the specificity of EEG to predict good outcome compared to only assessing background pattern without taking reactivity into account. CONCLUSION: Nearly one-third of comatose patients resuscitated after CA had a non-highly malignant and reactive EEG that was associated with a good long-term outcome. Reactivity testing should be routinely performed since preserved EEG reactivity contributed to prognostic performance.
Department of Clinical Neurophysiology Karolinska University Hospital Stockholm Sweden
Department of Clinical Neurophysiology Royal Victoria Hospital Belfast Ireland
Department of Clinical Sciences Anaesthesia and Intensive Care Lund University Malmö Sweden
Department of Clinical Sciences Lund Cardiology Lund University Lund Sweden
Department of Clinical Sciences Lund Clinical Neurophysiology Lund University Lund Sweden
Department of Clinical Sciences Lund Neurology Lund University Lund Sweden
Department of Intensive Care Medicine Bern University Hospital University of Bern Bern Switzerland
Department of Neurology Centre Hospitalier Universitaire de Nantes Nantes France
Department of Neurology Erasme University Hospital Université Libre de Bruxelles Brussels Belgium
Department of Neurology Inselspital Bern University Hospital University of Bern Bern Switzerland
Department of Neurology Kantonsspital St Gallen St Gallen Switzerland
Department of Neurology University Hospital and University of Lausanne Lausanne Switzerland
Department of Neurology University Hospital of Trieste Trieste Italy
Department of Neurology University Hospital Zurich Zurich Switzerland
Department of Neurology Yale University School of Medicine New Haven CT USA
General University Hospital Prague Prague Czech Republic
Institute of Intensive Care Medicine University Hospital Zürich Zürich Switzerland
Intensive Care Department Kantonsspital St Gallen St Gallen Switzerland
Intensive Care Unit University Hospital of Trieste Trieste Italy
Intensive Care Unit Versailles Hospital France
Section for Clinical Neurophysiology Department of Neurology Oslo University Hospital Oslo Norway
Citace poskytuje Crossref.org
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