| Hypothermia-treated cardiac arrest patients with good neurological outcome differ early in quantitative variables of EEG suppression and epileptiform activity. | |
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MedLine Citation:
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PMID: 19487928 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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 degrees 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. |
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Authors:
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Johanna E Wennervirta; Miikka J Ermes; S Marjaana Tiainen; Tapani K Salmi; Marja S Hynninen; Mika O K Särkelä; Markku J Hynynen; Ulf-Håkan Stenman; Hanna E Viertiö-Oja; Kari-Pekka Saastamoinen; Ville Y Pettilä; Anne P Vakkuri |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Critical care medicine Volume: 37 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-07-17 Completed Date: 2009-08-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 2427-35 Citation Subset: AIM; IM |
Affiliation:
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Intensive Care Units, Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. johanna.wennervirta@hus.fi |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Cerebrovascular Circulation Electroencephalography* Female Finland Health Status Indicators* Heart Arrest / therapy* Humans Hypothermia, Induced* Hypoxia-Ischemia, Brain / diagnosis* Male Middle Aged Prospective Studies Sensitivity and Specificity Time Factors Treatment Outcome |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2009 Aug;37(8):2485-6
[PMID:
19609125
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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