Prognostic role of EEG identical bursts in patients after cardiac arrest: Multimodal correlation.

Détails

ID Serval
serval:BIB_61CE1CC0713B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Prognostic role of EEG identical bursts in patients after cardiac arrest: Multimodal correlation.
Périodique
Resuscitation
Auteur(s)
Barbella G., Novy J., Marques-Vidal P., Oddo M., Rossetti A.O.
ISSN
1873-1570 (Electronic)
ISSN-L
0300-9572
Statut éditorial
Publié
Date de publication
01/03/2020
Peer-reviewed
Oui
Volume
148
Pages
140-144
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
EEG burst-suppression (BS) heralds poor outcome after cardiac arrest (CA). Within this pattern, identical bursts (IB) have been suggested to be absolutely specific, in isolation. We assessed IB prevalence and their added predictive value for poor outcome in a multimodal prognostic approach.
We retrospectively analyzed a registry of comatose adults with CA (April 2011-February 2019), undergoing EEG at 5-36 h and 36-72 h. SB and IB were visually assessed. Cerebral Performance Categories (CPC) at 3 months were dichotomized as "good" (CPC 1-2), or "poor" (CPC 3-5). Sensitivity, specificity, positive, negative predictive values of BS and IB for poor outcome were calculated. A multimodal prognostic score was created assigning one point each to unreactive and epileptiform EEG, pupillary light reflex and SSEPs absence, NSE > 75 μg/l. In a second score, IB were added; predictive performances were compared using Receiver Operating Characteristic (ROC) curves.
Of 522 patients, 147 (28%) had BS in any EEG (10 [7%] had good outcome and 129 [88%] died). Of them, 53/147 (36%, 10% of total) showed IB, 47/53 (89%) of which within 36 h. IB were 100% specific for poor outcome, and associated with higher serum NSE than BS. However, there was no significant difference between the scores with and without IB for CPC 3-5 (p = 0.116).
IB occur in 10% of patients after CA. In our multimodal context, IB, albeit being very specific for poor outcome, seem redundant with other predictors.
Mots-clé
Burst-suppression, Coma, EEG, Outcome, Postanoxic
Pubmed
Web of science
Création de la notice
06/02/2020 18:49
Dernière modification de la notice
03/05/2020 7:02
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