Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest

RESUSCITATION

卷:138

Article

Caporro, Matteo¹  Rossetti, Andrea O.^2,3  Seiler, Andrea¹  Kustermann, Thomas^3,4  Nguissi, Nathalie A. Nguepnjo^3,4  Pfeiffer, Christian^3,4,5  Zimmermann, Rebekka¹  Haenggi, Matthias⁶  Oddo, Mauro^3,7  De Lucia, Marzia^3,4  Zubler, Frederic¹ 

[1] Univ Bern, Dept Neurol, Inselspital, Univ Hosp Bern, Bern, Switzerland

[2] Univ Hosp CHUV, Dept Neurol, Lausanne, Switzerland

[3] Univ Lausanne, Lausanne, Switzerland

[4] Univ Hosp CHUV, Lab Rech Neuroimagerie LREN, Lausanne, Switzerland

[5] Univ Zurich, Dept Psychol, Zurich, Switzerland

[6] Univ Bern, Dept Intens Care Med, Inselspital, Univ Hosp Bern, Bern, Switzerland

[7] Univ Hosp CHUV, Dept Intens Care Med, Lausanne, Switzerland

关键词: Cardiac arrest;    Coma;    Prognostication;    EEG;    EMG;    Reactivity;   

DOI  :  10.1016/j.resuscitation.2019.03.014

来源: Elsevier

【 摘 要 】

Aim: To assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest. Methods: 184 adult patients from a multi-centric prospective register who underwent an early EEG after cardiac arrest were included. Auditory and somatosensory stimulation was performed during EEG-recording. EEG reactivity (EEG-R) and EMG reactivity (EMG-R) were retrospectively assessed visually by board-certified electroencephalographers, and compared with clinical outcome (cerebral performance category, CPC) at three months. A favorable functional outcome was defined as CPC 1-2, an unfavorable outcome as CPC 3-5. Results: Both EEG-R and EMG-R were predictors for good outcome (EEG-R accuracy 72% (95%-CI 66-79), sensitivity 86% (78-93), specificity 60% (50-69), EMG-R accuracy 65% (58-72), sensitivity 61% (51-75), specificity 69% (60-78)). When reactivity was defined as EEG-R and/or EMG-R, the accuracy was 73% (67-70), the sensitivity 94% (90-99), and the specificity 53% (43-63). Conclusion: Taking EMG into account when assessing reactivity of EEG seems to reduce false negative predictions for identifying patients with favorable outcome after cardiac arrest.

【 授权许可】

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