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Stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) in comatose survivors of cardiac arrest: Characteristics and prognostic value.
MedLine Citation:
PMID:  22857875     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To analyze the prevalence of stimulus-induced rhythmic, periodic or ictal discharges (SIRPIDs) in patients with coma after cardiac arrest (CA) and therapeutic hypothermia (TH) and to examine their potential association with outcome. METHODS: We studied our prospective cohort of adult survivors of CA treated with TH, assessing SIRPIDs occurrence and their association with 3-month outcome. Only univariated analyses were performed. RESULTS: 105 patients with coma after CA who underwent electroencephalogram (EEG) during TH and normothermia (NT) were studied. Fifty-nine patients (56%) survived, and 48 (46%) had good neurological recovery. The prevalence of SIRPIDs was 13.3% (14/105 patients), of whom 6 occurred during TH (all died), and 8 in NT (3 survived, 1 with good neurological outcome); none had SIRPIDs at both time-points. SIRPIDs were associated with discontinuous or non-reactive EEG background and were a robustly related to poor neurological outcome (p<0.001). CONCLUSION: This small series provides preliminary univariate evidence that in patients with coma after CA, SIRPIDs are associated with poor outcome, particularly when occurring during in therapeutic hypothermia. However, survival with good neurological recovery may be observed when SIRPIDs arise in the post-rewarming normothermic phase. SIGNIFICANCE: This study provides clinicians with new information regarding the SIRPIDs prognostic role in patients with coma after cardiac arrest.
Authors:
Vincent Alvarez; Mauro Oddo; Andrea O Rossetti
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-31
Journal Detail:
Title:  Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology     Volume:  -     ISSN:  1872-8952     ISO Abbreviation:  Clin Neurophysiol     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-8-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883319     Medline TA:  Clin Neurophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Clinical Neurosciences, Switzerland.
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