Aller au contenu principal
Accès ouvert déclaré 2024 article

The predictive value of highly malignant EEG patterns after cardiac arrest: evaluation of the ERC-ESICM recommendations

42Citations signalées, ce qui n’est pas une note de qualité
11Institutions déclarées
6Pays d’affiliation déclarés

Rattachement africain : it, se, dk, de, ch, au. Niveau de preuve : code pays fourni par la source.

Le résumé fourni par la source

PURPOSE: The 2021 guidelines endorsed by the European Resuscitation Council (ERC) and the European Society of Intensive Care Medicine (ESICM) recommend using highly malignant electroencephalogram (EEG) patterns (HMEP; suppression or burst-suppression) at > 24 h after cardiac arrest (CA) in combination with at least one other concordant predictor to prognosticate poor neurological outcome. We evaluated the prognostic accuracy of HMEP in a large multicentre cohort and investigated the added value of absent EEG reactivity. METHODS: This is a pre-planned prognostic substudy of the Targeted Temperature Management trial 2. The presence of HMEP and background reactivity to external stimuli on EEG recorded > 24 h after CA was prospectively reported. Poor outcome was measured at 6 months and defined as a modified Rankin Scale score of 4-6. Prognostication was multimodal, and withdrawal of life-sustaining therapy (WLST) was not allowed before 96 h after CA. RESULTS: 845 patients at 59 sites were included. Of these, 579 (69%) had poor outcome, including 304 (36%) with WLST due to poor neurological prognosis. EEG was recorded at a median of 71 h (interquartile range [IQR] 52-93) after CA. HMEP at > 24 h from CA had 50% [95% confidence interval [CI] 46-54] sensitivity and 93% [90-96] specificity to predict poor outcome. Specificity was similar (93%) in 541 patients without WLST. When HMEP were unreactive, specificity improved to 97% [94-99] (p = 0.008). CONCLUSION: The specificity of the ERC-ESICM-recommended EEG patterns for predicting poor outcome after CA exceeds 90% but is lower than in previous studies, suggesting that large-scale implementation may reduce their accuracy. Combining HMEP with an unreactive EEG background significantly improved specificity. As in other prognostication studies, a self-fulfilling prophecy bias may have contributed to observed results.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.

Le contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref
The predictive value of highly malignant EEG patterns after cardiac arrest: evaluation of the ERC-ESICM recommendations
Date Crossref
01/01/2024
Éditeur
Springer Science and Business Media LLC
Type
journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.

Les institutions déclarées

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Les sujets associés

Cardiac Arrest and ResuscitationIntensive Care Unit Cognitive DisordersAnesthesia and Sedative Agents

BNTIC News n’est pas le producteur de ces données. Les publications sont interrogées à la demande dans Crossref, OpenAIRE, DOAJ, Europe PMC, HAL, DataCite, AfricArXiv, ROR et la Banque mondiale, sans clé d’accès. OpenAlex reste optionnel. Aucun service payant n’est nécessaire et aucune donnée externe n’est enregistrée en base. Consulter les sources et leurs limites.