Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.

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Serval ID
serval:BIB_2653C51F5960
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.
Journal
Neurocritical care
Author(s)
Tsetsou S., Novy J., Pfeiffer C., Oddo M., Rossetti A.O.
ISSN
1556-0961 (Electronic)
ISSN-L
1541-6933
Publication state
Published
Issued date
02/2018
Peer-reviewed
Oui
Volume
28
Number
1
Pages
104-109
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C.
In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5).
We analyzed 61 patients. The presence of two or more predictors out of, unreactive electroencephalogram (EEG) background, epileptiform EEG, absent pupillary and/or corneal reflex, early myoclonus, bilaterally absent cortical somatosensory evoked potentials, and serum NSE >75 μg/l, had a high specificity for predicting mortality (positive predictive value [PPV] = 1.00, 95% CI 0.87-1.00) and poor outcome (PPV = 1.00, 95% CI 0.80-1.00). Reactive EEG background was highly sensitive for predicting good outcome (0.95, 95% CI 0.74-0.99).
Prediction of outcome after CA and TTM targeting 36 °C seems valid in adults using the same features tested at 33 °C. A reactive EEG under TTM appears highly sensitive for good outcome.
Keywords
Adult, Aged, Aged, 80 and over, Electroencephalography/methods, Female, Follow-Up Studies, Heart Arrest/blood, Heart Arrest/diagnosis, Heart Arrest/physiopathology, Heart Arrest/therapy, Humans, Hypothermia, Induced/methods, Male, Middle Aged, Neurologic Examination/methods, Outcome Assessment (Health Care), Phosphopyruvate Hydratase/blood, Prognosis, Cardiac arrest, Electroencephalogram, Prognostication
Pubmed
Web of science
Open Access
Yes
Create date
22/12/2017 11:15
Last modification date
04/10/2019 5:08
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