The effect of sedation and time after cardiac arrest on coma outcome prognostication based on EEG power spectra.

Autor:	Pelentritou A; Laboratoire de Recherche en Neuroimagerie (LREN), University Hospital (CHUV) & University of Lausanne, 1011 Lausanne, Switzerland., Nguissi NAN; Laboratoire de Recherche en Neuroimagerie (LREN), University Hospital (CHUV) & University of Lausanne, 1011 Lausanne, Switzerland., Iten M; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland., Haenggi M; Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, 3010 Bern, Switzerland., Zubler F; Department of Neurology, Spitalzentrum Biel, University of Bern, 2501 Biel, Switzerland., Rossetti AO; Department of Clinical Neurosciences, University Hospital (CHUV) & University of Lausanne, 1011 Lausanne, Switzerland., De Lucia M; Laboratoire de Recherche en Neuroimagerie (LREN), University Hospital (CHUV) & University of Lausanne, 1011 Lausanne, Switzerland.
Jazyk:	angličtina
Zdroj:	Brain communications [Brain Commun] 2023 Jun 28; Vol. 5 (4), pp. fcad190. Date of Electronic Publication: 2023 Jun 28 (Print Publication: 2023).
DOI:	10.1093/braincomms/fcad190
Abstrakt:	Early prognostication of long-term outcome of comatose patients after cardiac arrest remains challenging. Electroencephalography-based power spectra after cardiac arrest have been shown to help with the identification of patients with favourable outcome during the first day of coma. Here, we aim at comparing the power spectra prognostic value during the first and second day after coma onset following cardiac arrest and to investigate the impact of sedation on prognostication. In this cohort observational study, we included comatose patients ( N = 91) after cardiac arrest for whom resting-state electroencephalography was collected on the first and second day after cardiac arrest in four Swiss hospitals. We evaluated whether the average power spectra values at 4.6-15.2 Hz were predictive of patients' outcome based on the best cerebral performance category score at 3 months, with scores ranging from 1 to 5 and dichotomized as favourable (1-2) and unfavourable (3-5). We assessed the effect of sedation and its interaction with the electroencephalography-based power spectra on patient outcome prediction through a generalized linear mixed model. Power spectra values provided 100% positive predictive value (95% confidence intervals: 0.81-1.00) on the first day of coma, with correctly predicted 18 out of 45 favourable outcome patients. On the second day, power spectra values were not predictive of patients' outcome (positive predictive value: 0.46, 95% confidence intervals: 0.19-0.75). On the first day, we did not find evidence of any significant contribution of sedative infusion rates to the patient outcome prediction ( P > 0.05). Comatose patients' outcome prediction based on electroencephalographic power spectra is higher on the first compared with the second day after cardiac arrest. Sedation does not appear to impact patient outcome prediction. Competing Interests: The authors report no competing interests. (© The Author(s) 2023. Published by Oxford University Press on behalf of the Guarantors of Brain.)
Databáze:	MEDLINE
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