Association between somatosensory evoked potentials and EEG in comatose patients after cardiac arrest.

OBJECTIVE

To analyze the association between SSEP results and EEG results in comatose patients after cardiac arrest, including the added value of repeated SSEP measurements.

METHODS

Continuous EEG was measured in 619 patients during the first 3-5 days after cardiac arrest. SSEPs were recorded daily in the first 55 patients, and on indication in later patients. EEGs were visually classified at 12, 24, 48, and 72 h after cardiac arrest, and at the time of SSEP. Outcome at 6 m was dichotomized as good (Cerebral Performance Category 1-2) or poor (CPC 3-5). SSEP and EEG results were related to outcome. Additionally, SSEP results were related to the EEG patterns at the time of SSEP.

RESULTS

Absent SSEP responses and suppressed or synchronous EEG on suppressed background ≥24 h after cardiac arrest were invariably associated with poor outcome. SSEP and EEG identified different patients with poor outcome (joint sensitivity 39% at specificity 100%). N20 responses were always preserved in continuous traces at >8 Hz. Absent SSEPs did not re-emerge during the first five days.

CONCLUSIONS

SSEP and EEG results may diverge after cardiac arrest.

SIGNIFICANCE

SSEP and EEG together identify more patients without chance of recovery than one of these alone.