Amplitude-integrated EEG (aEEG) predicts outcome after cardiac arrest and induced hypothermia
Amplitude-integrated EEG (aEEG) predicts outcome after cardiac arrest and induced hypothermia
复制标题
DOI：
10.1007/s00134-006-0178-6
复制
发表时间：
2006-06-01
影响因子：
38.9
通讯作者：
Friberg, Hans
中科院分区：
文献类型：
--
作者：
Rundgren, Malin;Rosen, Ingmar;Friberg, Hans
评价连续振幅积分脑电图（aEEG）作为低温治疗心脏骤停患者生存和神经结局的预后工具的应用。前瞻性观察研究。大学医院多学科重症监护室。心脏骤停昏迷幸存者接受诱导低温治疗24小时。到达ICU后开始aEEG记录，并持续至患者恢复意识，或如果患者仍处于昏迷状态，则不超过120小时。ICU医生无法获得aEEG记录，aEEG描记由不了解患者临床状态的神经生理学家解释。只有临床上可见的癫痫发作被治疗。34个连续低血压治疗心脏骤停的幸存者被纳入。在常温下（心脏骤停后平均37小时），aEEG模式对结局具有鉴别力。所有20例连续aEEG患者此时均恢复意识，而14例病理性aEEG模式（平坦、抑制-爆发或癫痫持续状态）患者未恢复意识并在医院死亡。患者从ICU出院后和6个月后，使用脑功能分类（CPC）量表进行神经学评估。随访6个月，18例患者存活，脑功能恢复良好（CPC 1-2）。aEEG是ICU环境中易于应用的方法。
To evaluate the use of continuous amplitude-integrated EEG (aEEG) as a prognostic tool for survival and neurological outcome in cardiac arrest patients treated with hypothermia.Prospective, observational study.Multidisciplinary intensive care unit in a university hospital.Comatose survivors of cardiac arrest were treated with induced hypothermia for 24 h. An aEEG recording was initiated upon arrival at the ICU and continued until the patient regained consciousness or, if the patient remained in coma, no longer than 120 h. The aEEG recording was not available to the ICU physician, and the aEEG tracings were interpreted by a neurophysiologist with no knowledge of the patient's clinical status. Only clinically visible seizures were treated.Thirty-four consecutive hypothermia-treated cardiac arrest survivors were included. At normothermia (mean 37 h after cardiac arrest), the aEEG pattern was discriminative for outcome. All 20 patients with a continuous aEEG at this time regained consciousness, whereas 14 patients with pathological aEEG patterns (flat, suppression-burst or status epilepticus) did not regain consciousness and died in hospital. Patients were evaluated neurologically upon discharge from the ICU and after 6 months, using the Cerebral Performance Category (CPC) scale. Eighteen patients were alive with a good cerebral outcome (CPC 1-2) at 6-month follow-up.A continuous aEEG pattern at the time of normothermia was discriminative for regaining consciousness. aEEG is an easily applied method in the ICU setting.