Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest.

Caporro, Matteo; Rossetti, Andrea O; Seiler, Andrea; Kustermann, Thomas; Nguepnjo Nguissi, Nathalie Ata; Pfeiffer, Christian; Zimmermann, Rebekka; Hänggi, Matthias; Oddo, Mauro; De Lucia, Marzia; Zubler, Frederic (2019). Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest. Resuscitation, 138, pp. 146-152. Elsevier Science Ireland 10.1016/j.resuscitation.2019.03.014

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AIM To assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest. METHODS 184 adult patients from a multi-centric prospective register who underwent an early EEG after cardiac arrest were included. Auditory and somatosensory stimulation was performed during EEG-recording. EEG reactivity (EEG-R) and EMG reactivity (EMG-R) were retrospectively assessed visually by board-certified electroencephalographers, and compared with clinical outcome (cerebral performance category, CPC) at three months. A favorable functional outcome was defined as CPC 1-2, an unfavorable outcome as CPC 3-5. RESULTS Both EEG-R and EMG-R were predictors for good outcome (EEG-R accuracy 72% (95%-CI 66-79), sensitivity 86% (78-93), specificity 60% (50-69); EMG-R accuracy 65% (58-72), sensitivity 61% (51-75), specificity 69% (60-78)). When reactivity was defined as EEG-R and/or EMG-R, the accuracy was 73% (67-70), the sensitivity 94% (90-99), and the specificity 53% (43-63). CONCLUSION Taking EMG into account when assessing reactivity of EEG seems to reduce false negative predictions for identifying patients with favorable outcome after cardiac arrest.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Caporro, Matteo and Hänggi, Matthias

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0300-9572

Publisher:

Elsevier Science Ireland

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

15 Jul 2019 11:19

Last Modified:

15 Jul 2019 11:29

Publisher DOI:

10.1016/j.resuscitation.2019.03.014

PubMed ID:

30885825

Uncontrolled Keywords:

EEG EMG cardiac arrest coma prognostication reactivity

BORIS DOI:

10.7892/boris.128800

URI:

https://boris.unibe.ch/id/eprint/128800

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