Astrid B Glimmerveen1, Barry J Ruijter2, Hanneke M Keijzer3, Marleen C Tjepkema-Cloostermans4, Michel J A M van Putten4, Jeannette Hofmeijer5. 1. Department of Neurology, Rijnstate Hospital, P.O. Box 9555, 6800 TA Arnhem, The Netherlands. Electronic address: aglimmerveen@rijnstate.nl. 2. Clinical Neurophysiology, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands. 3. Department of Neurology, Rijnstate Hospital, P.O. Box 9555, 6800 TA Arnhem, The Netherlands; Department of Intensive Care Medicine and Neurology, Donders Institute for Brain Cognition, and Behaviour, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. 4. Clinical Neurophysiology, Technical Medical Centre, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; Department of Neurology and Clinical Neurophysiology, Medisch Spectrum Twente, P.O. Box 50000, 7500 KA Enschede, The Netherlands. 5. 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.
Abstract
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.
OBJECTIVE: To analyze the association between SSEP results and EEG results in comatosepatients 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.
Authors: Jonathan Elmer; Patrick J Coppler; Teresa L May; Karen Hirsch; John Faro; Pawan Solanki; McKenzie Brown; Jacob S Puyana; Jon C Rittenberger; Clifton W Callaway Journal: Resuscitation Date: 2020-06-09 Impact factor: 5.262
Authors: Astrid B Glimmerveen; Hanneke M Keijzer; Barry J Ruijter; Marleen C Tjepkema-Cloostermans; Michel J A M van Putten; Jeannette Hofmeijer Journal: Front Neurol Date: 2020-04-28 Impact factor: 4.003
Authors: Stanley D T Pham; Hanneke M Keijzer; Barry J Ruijter; Antje A Seeber; Erik Scholten; Gea Drost; Walter M van den Bergh; Francois H M Kornips; Norbert A Foudraine; Albertus Beishuizen; Michiel J Blans; Jeannette Hofmeijer; Michel J A M van Putten; Marleen C Tjepkema-Cloostermans Journal: Neurocrit Care Date: 2022-03-02 Impact factor: 3.532