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Báo cáo y học: "Prognostic value of continuous EEG monitoring during therapeutic hypothermia after cardiac arrest"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Prognostic value of continuous EEG monitoring during therapeutic hypothermia after cardiac arrest. | Rossetti et al. Critical Care 2010 14 R173 http ccforum.eom content 14 5 R173 c CRITICAL CARE RESEARCH Open Access Prognostic value of continuous EEG monitoring during therapeutic hypothermia after cardiac arrest 1Ỷ 2Ỷ 2 3 2 Andrea O Rossetti Luis A Urbano Frederik Delodder Peter W Kaplan Mauro Oddo Abstract Introduction Continuous EEG cEEG is increasingly used to monitor brain function in neuro-ICU patients. However its value in patients with coma after cardiac arrest CA particularly in the setting of therapeutic hypothermia TH is only beginning to be elucidated. The aim of this study was to examine whether cEEG performed during TH may predict outcome. Methods From April 2009 to April 2010 we prospectively studied 34 consecutive comatose patients treated with TH after CA who were monitored with cEEG initiated during hypothermia and maintained after rewarming. EEG background reactivity to painful stimulation was tested. We analyzed the association between cEEG findings and neurologic outcome assessed at 2 months with the Glasgow-Pittsburgh Cerebral Performance Categories CPC . Results Continuous EEG recording was started 12 6 hours after CA and lasted 30 11 hours. Nonreactive cEEG background 12 of 15 75 among nonsurvivors versus none of 19 0 survivors P 0.001 and prolonged discontinuous burst-suppression activity 11 of 15 73 versus none of 19 P 0.001 were significantly associated with mortality. EEG seizures with absent background reactivity also differed significantly seven of 15 47 versus none of 12 0 P 0.001 . In patients with nonreactive background or seizures epileptiform discharges on cEEG no improvement was seen after TH. Nonreactive cEEG background during TH had a positive predictive value of 100 95 confidence interval CI 74 to 100 and a false-positive rate of 0 95 CI 0 to 18 for mortality. All survivors had cEEG background reactivity and the majority of them 14 74 of 19 had a favorable outcome CPC 1 or 2 . Conclusions Continuous EEG monitoring showing a .