Hypothermia-treated cardiac arrest patients with good neurological outcome differ early in quantitative variables of EEG suppression and epileptiform activity*
| Autor: | Miikka Ermes, Ulf-Håkan Stenman, Anne Vakkuri, S Marjaana Tiainen, Johanna Wennervirta, Tapani Salmi, Markku Hynynen, Mika Sarkela, Kari-Pekka Saastamoinen, Hanna E. Viertio-Oja, Marja Hynninen, Ville Pettilä |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Resuscitation Time Factors cardiac arrest Electroencephalography Critical Care and Intensive Care Medicine Sensitivity and Specificity Central nervous system disease recovery 03 medical and health sciences Epilepsy 0302 clinical medicine Hypothermia Induced Intensive care medicine Health Status Indicators Humans Prospective Studies EEG Prospective cohort study Finland Aged medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Middle Aged Hypothermia medicine.disease Heart Arrest Treatment Outcome Cerebrovascular Circulation Anesthesia Hypoxia-Ischemia Brain Ventricular fibrillation Female medicine.symptom hypothermia business electroencephalography 030217 neurology & neurosurgery |
| Zdroj: | Wennervirta, J E, Ermes, M, Tiainen, S M, Salmi, T K, Hynninen, M S, Särkelä, M O K, Hynynen, M J, Stenman, U-H, Viertiö-Oja, H E, Saastamoinen, K-P, Pettilä, V Y & Vakkuri, A P 2009, ' Hypothermia-treated cardiac arrest patients with good neurological outcome differ early in quantitative variables of EEG suppression and epileptiform activity ', Critical Care Medicine, vol. 37, no. 8, pp. 2427-2435 . https://doi.org/10.1097/CCM.0b013e3181a0ff84 |
| ISSN: | 0090-3493 |
| Popis: | Objective: To evaluate electroencephalogram-derived quantitative variables after out-of-hospital cardiac arrest.Design: Prospective study.Setting: University hospital intensive care unit.Patients: Thirty comatose adult patients resuscitated from a witnessed out-of-hospital ventricular fibrillation cardiac arrest and treated with induced hypothermia (33°C) for 24 hrs.Interventions: None.Measurements and Main Results:Electroencephalography was registered from the arrival at the intensive care unit until the patient was extubated or transferred to the ward, or 5 days had elapsed from cardiac arrest. Burst-suppression ratio, response entropy, state entropy, and wavelet subband entropy were derived. Serum neuron-specific enolase and protein 100B were measured. The Pulsatility Index of Transcranial Doppler Ultrasonography was used to estimate cerebral blood flow velocity. The Glasgow-Pittsburgh Cerebral Performance Categories was used to assess the neurologic outcome during 6 mos after cardiac arrest. Twenty patients had Cerebral Performance Categories of 1 to 2, one patient had a Cerebral Performance Categories of 3, and nine patients had died (Cerebral Performance Categories of 5). Burst-suppression ratio, response entropy, and state entropy already differed between good (Cerebral Performance Categories 1–2) and poor (Cerebral Performance Categories 3–5) outcome groups (p = .011, p = .011, p = .008) during the first 24 hrs after cardiac arrest. Wavelet subband entropy was higher in the good outcome group between 24 and 48 hrs after cardiac arrest (p = .050). All patients with status epilepticus died, and their wavelet subband entropy values were lower (p = .022). Protein 100B was lower in the good outcome group on arrival at ICU (p = .010). After hypothermia treatment, neuron-specific enolase and protein 100B values were lower (p = .002 for both) in the good outcome group. The Pulsatility Index was also lower in the good outcome group (p = .004).Conclusions: Quantitative electroencephalographic variables may be used to differentiate patients with good neurologic outcomes from those with poor outcomes after out-of-hospital cardiac arrest. The predictive values need to be determined in a larger, separate group of patients. |
| Databáze: | OpenAIRE |
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