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Yield of intermittent versus continuous EEG in comatose survivors of cardiac arrest treated with hypothermia

机译：低温治疗昏迷的心脏骤停幸存者中间歇性和连续性脑电图的产量

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IntroductionElectroencephalography (EEG) has a central role in the outcome prognostication in subjects with anoxic/hypoxic encephalopathy following a cardiac arrest (CA). Continuous EEG monitoring (cEEG) has been consistently developed and studied; however, its yield as compared to repeated standard EEG (sEEG) is unknown.MethodsWe studied a prospective cohort of comatose adults treated with therapeutic hypothermia (TH) after a CA. cEEG data regarding background activity and epileptiform components were compared to two 20-minute sEEGs extracted from the cEEG recording (one during TH, and one in early normothermia).ResultsThirty-four recordings were studied. During TH, the agreement between cEEG and sEEG was 97.1% (95% CI: 84.6 to 99.9%) for background discontinuity and reactivity evaluation, while it was 94.1% (95% CI 80.3 to 99.2%) regarding epileptiform activity. In early normothermia, we did not find any discrepancies. Thus, concordance results were very good during TH (kappa 0.83), and optimal during normothermia (kappa = 1). The median delay between CA and the first EEG reactivity testing was 18 hours (range: 4.75 to 25) for patients with perfect agreement and 10 hours (range: 5.75 to 10.5) for the three patients with discordant findings (P = 0.02, Wilcoxon).ConclusionsStandard intermittent EEG has comparable performance with continuous EEG both for variables important for outcome prognostication (EEG reactivity) and identification of epileptiform transients in this relatively small sample of comatose survivors of CA. This finding has an important practical implication, especially for centers where EEG resources are limited.
机译：简介脑电图（EEG）在心脏骤停（CA）后缺氧/缺氧性脑病患者的预后中起着核心作用。持续的脑电图监测（cEEG）一直得到发展和研究。然而，与重复标准EEG（sEEG）相比，其产量尚不清楚。方法我们研究了在CA后接受治疗性低温（TH）治疗的昏迷成年人的前瞻性队列。将与背景活动和癫痫样成分有关的cEEG数据与从cEEG记录中提取的两个20分钟sEEG进行了比较（一个在TH期间，一个在正常常温下）。结果研究了34个记录。在TH期间，背景不连续性和反应性评估中，cEEG和sEEG之间的一致性为97.1％（95％CI：84.6至99.9％），而癫痫样活性则为94.1％（95％CI 80.3至99.2％）。在早期的正常体温中，我们没有发现任何差异。因此，在TH期间，一致性结果非常好（kappa为0.83），在正常体温过程中的一致性结果最佳（kappa = 1）。完全同意的患者，CA与首次脑电反应性测试之间的中位延迟时间为18小时（范围：4.75至25），三位发现结果不一致的患者为10​​小时（范围：5.75至10.5）（P = 0.02，Wilcoxon）结论在这个相对较小的CA昏迷幸存者样本中，标准的间歇性EEG与对于预后重要的变量（EEG反应性）和癫痫样瞬变的识别均具有与连续EEG相当的性能。这一发现具有重要的实际意义，尤其是对于脑电资源有限的中心。

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