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EEG for good outcome prediction after cardiac arrest: A multicentre cohort study.
Turella, S; Dankiewicz, J; Ben-Hamouda, N; Nilsen, K B; Düring, J; Endisch, C; Engstrøm, M; Flügel, D; Gaspard, N; Grejs, A M; Haenggi, M; Haffey, S; Imbach, L; Johnsen, B; Kemlink, D; Leithner, C; Legriel, S; Lindehammar, H; Mazzon, G; Nielsen, N; Peyre, A; Ribalta Stanford, B; Roman-Pognuz, E; Rossetti, A O; Schrag, C; Valeriánová, A; Wendel-Garcia, P; Zubler, F; Cronberg, T; Westhall, E.
Afiliación
  • Turella S; Department of Clinical Sciences Lund, Clinical Neurophysiology, Lund University, Lund, Sweden.
  • Dankiewicz J; Department of Clinical Sciences Lund, Cardiology, Lund University, Lund, Sweden.
  • Ben-Hamouda N; Department of Adult Intensive Care Medicine, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
  • Nilsen KB; Section for Clinical Neurophysiology, Department of Neurology, Oslo University Hospital, Oslo, Norway.
  • Düring J; Department of Clinical Sciences, Anaesthesia and Intensive Care, Lund University, Malmö, Sweden.
  • Endisch C; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Department of Neurology and Experimental Neurology, Augustenburger Platz 1, 13353 Berlin, Germany.
  • Engstrøm M; Department of Clinical Neurophysiology, St. Olavs University Hospital and Department of Neuromedicine and Movement Science (INB) NTNU, Trondheim, Norway.
  • Flügel D; Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
  • Gaspard N; Department of Neurology, Erasme University Hospital, Université Libre de Bruxelles, Brussels, Belgium; Department of Neurology, Yale University School of Medicine, New Haven, CT, USA.
  • Grejs AM; Department of Intensive Care Medicine, Aarhus University Hospital and Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
  • Haenggi M; Department of Intensive Care Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Haffey S; Department of Clinical Neurophysiology, Royal Victoria Hospital, Belfast, Ireland.
  • Imbach L; Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
  • Johnsen B; Department of Clinical Medicine, Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
  • Kemlink D; Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
  • Leithner C; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt - Universität zu Berlin, Department of Neurology and Experimental Neurology, Augustenburger Platz 1, 13353 Berlin, Germany.
  • Legriel S; Intensive Care Unit, Versailles Hospital, France.
  • Lindehammar H; Clinical Neurophysiology, Department of Clinical and Experimental Medicine, Linköping University, Sweden.
  • Mazzon G; Department of Neurology, University Hospital of Trieste, Trieste, Italy.
  • Nielsen N; Department of Clinical Sciences Lund, Anesthesiology and Intensive Care Medicine, Helsingborg Hospital, Helsingborg, Sweden.
  • Peyre A; Department of Neurology, Centre Hospitalier Universitaire de Nantes, Nantes, France.
  • Ribalta Stanford B; Department of Clinical Neurophysiology, Karolinska University Hospital, Stockholm, Sweden.
  • Roman-Pognuz E; Intensive Care Unit, University Hospital of Trieste, Trieste, Italy.
  • Rossetti AO; Department of Neurology, University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.
  • Schrag C; Intensive Care Department, Kantonsspital St. Gallen, St. Gallen, Switzerland.
  • Valeriánová A; General University Hospital in Prague, Prague, Czech Republic.
  • Wendel-Garcia P; Institute of Intensive Care Medicine, University Hospital Zürich, Zürich, Switzerland.
  • Zubler F; Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
  • Cronberg T; Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.
  • Westhall E; Department of Clinical Sciences Lund, Clinical Neurophysiology, Lund University, Lund, Sweden. Electronic address: erik.westhall@med.lu.se.
Resuscitation ; 202: 110319, 2024 09.
Article en En | MEDLINE | ID: mdl-39029579
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Electroencefalografía / Paro Cardíaco Extrahospitalario / Hipotermia Inducida Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Resuscitation Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Irlanda
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Electroencefalografía / Paro Cardíaco Extrahospitalario / Hipotermia Inducida Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Resuscitation Año: 2024 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Irlanda