Wu Cheng-I, Hsu Pai-Feng, Lee I-Hsin, Lin Yenn-Jiang, Lin Chun-Fu, Pan Ju-Pin, Hsu Teh-Fu, How Chorng-Kuang, Kwan Shang-Yeong, Chung Fa-Po, Wu Cheng-Hsueh, Chen Shih-Ann
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital.
Institute of Clinical Medicine, National Yang Ming Chiao Tung University.
Acta Cardiol Sin. 2021 Nov;37(6):632-642. doi: 10.6515/ACS.202111_37(6).20210630B.
Amplitude-integrated electroencephalography (aEEG) has been used as a tool to recognize brain activity in children with hypoxic encephalopathy.
To assess the prognostic value of aEEG during the post-resuscitation period of adult cardiogenic cardiac arrest, comatose survivors were monitored within 24 h of a return of spontaneous circulation using aEEG.
Forty-two consecutive patients experiencing cardiac arrest were retrospectively enrolled, and a return of spontaneous circulation was achieved in all cases. These patients were admitted to the Coronary Intensive Care Unit due to cardiogenic cardiac arrest. The primary outcome was the best neurologic outcome within 6 months after resuscitation, and the registered patients were divided into two groups based on the Cerebral Performance Category (CPC) scale (CPC 1-2, good neurologic function group; CPC 3-5, poor neurologic function group). All patients received an aEEG examination within 24 h after a return of spontaneous circulation, and the parameters and patterns of aEEG recordings were compared.
Nineteen patients were in the good neurologic function group, and 23 were in the poor group. The four voltage parameters (minimum, maximum, span, average) of the aEEG recordings in the good neurologic function groups were significantly higher than in the poor group. Moreover, the continuous pattern, but not the status epilepticus or burst suppression patterns, could predict mid-term good neurologic function.
aEEG can be used to predict neurologic outcomes based on the recordings' parameters and patterns in unconscious adults who have experienced a cardiac collapse, resuscitation, and return of spontaneous circulation.
振幅整合脑电图(aEEG)已被用作识别缺氧性脑病患儿脑活动的工具。
为评估成人心源性心脏骤停复苏后期间aEEG的预后价值,对昏迷幸存者在自主循环恢复后24小时内使用aEEG进行监测。
回顾性纳入42例连续发生心脏骤停的患者,所有病例均实现自主循环恢复。这些患者因心源性心脏骤停入住冠心病重症监护病房。主要结局是复苏后6个月内最佳神经功能结局,根据脑功能分类(CPC)量表将登记患者分为两组(CPC 1 - 2,神经功能良好组;CPC 3 - 5,神经功能不良组)。所有患者在自主循环恢复后24小时内接受aEEG检查,并比较aEEG记录的参数和模式。
神经功能良好组19例,不良组23例。神经功能良好组aEEG记录的四个电压参数(最小值、最大值、峰峰值、平均值)显著高于不良组。此外,持续模式而非癫痫持续状态或爆发抑制模式可预测中期良好神经功能。
aEEG可用于根据经历心脏骤停、复苏及自主循环恢复的昏迷成人的记录参数和模式预测神经功能结局。