Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest
| Autor: | Johanna Hästbacka, Tero Ala-Kokko, Marjaana Tiainen, Jouko V. Laurila, Juha Koskenkari, Daniel Strbian, Eero Väyrynen, Mika Kallio, Jussi Toppila, Jukka Kortelainen, Kirsi Rantanen, Markus B. Skrifvars |
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| Přispěvatelé: | HUS Neurocenter, Neurologian yksikkö, Department of Neurosciences, HUS Internal Medicine and Rehabilitation, HUS Medical Imaging Center, Department of Diagnostics and Therapeutics, Kliinisen neurofysiologian yksikkö, HUS Diagnostic Center, University of Helsinki, HUS Emergency Medicine and Services, Helsinki University Hospital Area, Clinicum, HUS Perioperative, Intensive Care and Pain Medicine, Anestesiologian yksikkö |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Resuscitation
THERAPEUTIC HYPOTHERMIA Hypoxic-Ischemic encephalopathy cardiac arrest 030204 cardiovascular system & hematology Emergency Nursing Electroencephalography Return of spontaneous circulation Propofol sedation 03 medical and health sciences 0302 clinical medicine Interquartile range Predictive Value of Tests Medicine Humans Prospective Studies EEG hypoxic-ischemic encephalopathy Prospective cohort study Propofol Outcome medicine.diagnostic_test propofol business.industry RESUSCITATION Early recovery 030208 emergency & critical care medicine CARE Prognosis Cardiac arrest 3126 Surgery anesthesiology intensive care radiology Heart Arrest Anesthesia Emergency Medicine PROGNOSTICATION outcome Cardiology and Cardiovascular Medicine business prognostication medicine.drug |
| Popis: | Aim of the study: EEG slow wave activity (SWA) has shown prognostic potential in post-resuscitation care. In this prospective study, we investigated the accuracy of continuously measured early SWA for prediction of the outcome in comatose cardiac arrest (CA) survivors. Methods: We recorded EEG with a disposable self-adhesive frontal electrode and wireless device continuously starting from ICU admission until 48 h from return of spontaneous circulation (ROSC) in comatose CA survivors sedated with propofol. We determined SWA by offline calculation of C-Trend® Index describing SWA as a score ranging from 0 to 100. The functional outcome was defined based on Cerebral Performance Category (CPC) at 6 months after the CA to either good (CPC 1–2) or poor (CPC 3–5). Results: Outcome at six months was good in 67 of the 93 patients. During the first 12 h after ROSC, the median C-Trend Index value was 38.8 (interquartile range 28.0–56.1) in patients with good outcome and 6.49 (3.01–18.2) in those with poor outcome showing significant difference (p < 0.001) at every hour between the groups. The index values of the first 12 h predicted poor outcome with an area under curve of 0.86 (95% CI 0.61−0.99). With a cutoff value of 20, the sensitivity was 83.3% (69.6%–92.3%) and specificity 94.7% (83.4%–99.7%) for categorization of outcome. Conclusion: EEG SWA measured with C-Trend Index during propofol sedation offers a promising practical approach for early bedside evaluation of recovery of brain function and prediction of outcome after CA. |
| Databáze: | OpenAIRE |
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