Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.

S. Tsetsou; J. Novy; C. Pfeiffer; M. Oddo; A.O. Rossetti

Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C.

Fiche du document

Auteurs

Type de document

Articles

Périmètre

Publications

Langue

Anglais

Identifiants

doi: 10.1007/s12028-017-0393-8
issn: 1541-6933

Source

Serveur académique Lausannois

Relations

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/doi/10.1007/s12028-017-0393-8

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/pmid/28337603

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/eissn/1556-0961

Ce document est lié à :
info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:serval-BIB_2653C51F59602

Collection

Serveur Académique Lausannois

Organisation

Université de Lausanne et CHUV

Licences

info:eu-repo/semantics/openAccess , Copying allowed only for non-profit organizations , https://serval.unil.ch/disclaimer

Mots-clés 0

Adult; Aged; Aged, 80 and over; Electroencephalography/methods; Female; Follow-Up Studies; Heart Arrest/blood; Heart Arrest/diagnosis; Heart Arrest/physiopathology; Heart Arrest/therapy; Humans; Hypothermia, Induced/methods; Male; Middle Aged; Neurologic Examination/methods; Outcome Assessment (Health Care); Phosphopyruvate Hydratase/blood; Prognosis; Cardiac arrest; Electroencephalogram; Prognostication

Sujets proches En

Encephalography EEG

Citer ce document

S. Tsetsou et al., « Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C. », Serveur académique Lausannois, ID : 10.1007/s12028-017-0393-8

Partage / Export

Résumé 0

Targeted temperature management (TTM) represents the standard of care in comatose survivors after cardiac arrest (CA) and may be applied targeting 33° or 36 °C. While multimodal prognostication has been extensively tested for 33 °C, scarce information exists for 36 °C. In this cohort study, consecutive comatose adults after CA treated with TTM at 36 °C between July 2014 and October 2016 were included. A combination of neurological examination, electrophysiological features, and serum neuron-specific enolase (NSE) was evaluated for outcome prediction at 3 months (mortality; good outcome defined as cerebral performance categories (CPC) score of 1-2, poor outcome defined as CPC 3-5). We analyzed 61 patients. The presence of two or more predictors out of, unreactive electroencephalogram (EEG) background, epileptiform EEG, absent pupillary and/or corneal reflex, early myoclonus, bilaterally absent cortical somatosensory evoked potentials, and serum NSE >75 μg/l, had a high specificity for predicting mortality (positive predictive value [PPV] = 1.00, 95% CI 0.87-1.00) and poor outcome (PPV = 1.00, 95% CI 0.80-1.00). Reactive EEG background was highly sensitive for predicting good outcome (0.95, 95% CI 0.74-0.99). Prediction of outcome after CA and TTM targeting 36 °C seems valid in adults using the same features tested at 33 °C. A reactive EEG under TTM appears highly sensitive for good outcome.