Department of Neurology, Rijnstate Hospital, P.O. Box 9555, 6800 TA Arnhem, The Netherlands.
Clinical Neurophysiology, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
Clin Neurophysiol. 2019 Nov;130(11):2026-2031. doi: 10.1016/j.clinph.2019.08.022. Epub 2019 Aug 31.
To analyze the association between SSEP results and EEG results in comatose patients after cardiac arrest, including the added value of repeated SSEP measurements.
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.
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.
SSEP and EEG results may diverge after cardiac arrest.
SSEP and EEG together identify more patients without chance of recovery than one of these alone.
分析心脏骤停后昏迷患者的体感诱发电位（SSEP）结果与脑电图（EEG）结果之间的关系，包括重复 SSEP 测量的附加值。
在心脏骤停后第 1-5 天内，对 619 名患者连续进行 EEG 测量。在前 55 名患者中每天记录 SSEP，在后患者中根据指征记录。在心脏骤停后 12、24、48 和 72 小时以及 SSEP 时对 EEG 进行视觉分类，并对 6 个月时的结果进行分类，分为良好（脑功能状态分类 1-2 级）或不良（CPC 3-5 级）。将 SSEP 和 EEG 结果与预后相关联。此外，还将 SSEP 结果与 SSEP 时的 EEG 模式相关联。
心脏骤停后 24 小时以上 SSEP 无反应且 EEG 抑制或同步，背景抑制≥24 小时，与预后不良始终相关。SSEP 和 EEG 可识别不同预后不良的患者（特异性为 100%时联合敏感性为 39%）。在>8 Hz 的连续迹线上，N20 反应始终保持不变。SSEP 在最初五天内并未重新出现。
心脏骤停后 SSEP 和 EEG 结果可能会出现分歧。
SSEP 和 EEG 一起可识别出比单独使用其中任何一种方法更多的无恢复机会的患者。
