The prognostic value of continuous amplitude-integrated electroencephalogram applied immediately after return of spontaneous circulation in therapeutic hypothermia-treated cardiac arrest patients
The prognostic value of continuous amplitude-integrated electroencephalogram applied immediately after return of spontaneous circulation in therapeutic hypothermia-treated cardiac arrest patients
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DOI：
10.1016/j.resuscitation.2012.09.031
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发表时间：
2013-02-01
期刊：
影响因子：
6.5
通讯作者：
Shon, Young Min
中科院分区：
文献类型：
--
作者：
Oh, Sang Hoon;Park, Kyu Nam;Shon, Young Min
简介：本研究的目的是研究连续振幅整合脑电图（aEEG）应用后立即恢复自主循环（ROSC）在治疗性低温（TH）治疗的心脏骤停patients.Methods的预后价值：从2010年9月至2011年8月，我们前瞻性地研究了昏迷患者治疗TH心脏骤停后，监测aEEG。在急诊科进行ROSC后尽快进行前额监测，并持续至意识恢复、死亡或ROSC后72 h。出院时采用脑功能分类（CPC）量表评估神经功能结局，CPC评分1分或2分为神经功能良好。结果：共纳入55例TH治疗患者。在ROSC后中位数96分钟开始监测（四分位距，49-174）。出院时，28例患者的CPC为1-2，27例患者的CPC为3-5。17例患者在监测开始时有连续正常电压（CNV）迹线，该电压与良好结局密切相关（16/17 [94.1%];灵敏度和特异性分别为57.1%和96.3%）。在记录期间内没有CNV痕迹的发展准确地预测了不良结局（21/21 [100%];灵敏度和特异性分别为77.8和100%）。结论：在TH治疗的心脏骤停患者中，在ROSC后立即将aEEG中的初始CNV痕迹应用于前额是良好结局的良好早期预测因子。相反，在72小时内没有CNV痕迹的发展是预后不良的准确和可靠的预测因素，假阳性率为0%。(C)2012爱思唯尔爱尔兰有限公司保留所有权利。
Introduction: The purpose of this study was to examine the prognostic value of continuous amplitude-integrated electroencephalogram (aEEG) applied immediately after return of spontaneous circulation (ROSC) in therapeutic hypothermia (TH)-treated cardiac arrest patients.Methods: From September 2010 to August 2011, we prospectively studied comatose patients treated with TH after cardiac arrest who were monitored with aEEG. Monitoring at the forehead was applied as soon as possible after ROSC in the emergency department and continued until recovery of consciousness, death, or 72 h after ROSC. Neurological outcome was assessed with the Cerebral Performance Category (CPC) scale at hospital discharge, and good neurological outcome was defined as a CPC score of 1 or 2.Results: A total of 55 TH-treated patients were included. Monitoring started at a median of 96 min after ROSC (interquartile range, 49-174). At discharge, 28 patients had a CPC of 1-2, and 27 patients had a CPC of 3-5. Seventeen patients had a continuous normal voltage (CNV) trace at the start of monitoring, and this voltage was strongly associated with a good outcome (16/17 [94.1%]; sensitivity and specificity of 57.1 and 96.3%, respectively). No development of a CNV trace within the recorded period accurately predicted a poor outcome (21/21 [100%]; sensitivity and specificity of 77.8 and 100%, respectively).Conclusions: An initial CNV trace in aEEG applied to forehead immediately after ROSC is a good early predictor of a good outcome in TH-treated cardiac arrest patients. Conversely, no development of a CNV trace within 72 h is an accurate and reliable predictor of a poor outcome with a false-positive rate of 0%. (C) 2012 Elsevier Ireland Ltd. All rights reserved.