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  • Title: Electromyographic reactivity measured with scalp-EEG contributes to prognostication after cardiac arrest.
    Author: Caporro M, Rossetti AO, Seiler A, Kustermann T, Nguepnjo Nguissi NA, Pfeiffer C, Zimmermann R, Haenggi M, Oddo M, De Lucia M, Zubler F.
    Journal: Resuscitation; 2019 May; 138():146-152. PubMed ID: 30885825.
    Abstract:
    AIM: To assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest. METHODS: 184 adult patients from a multi-centric prospective register who underwent an early EEG after cardiac arrest were included. Auditory and somatosensory stimulation was performed during EEG-recording. EEG reactivity (EEG-R) and EMG reactivity (EMG-R) were retrospectively assessed visually by board-certified electroencephalographers, and compared with clinical outcome (cerebral performance category, CPC) at three months. A favorable functional outcome was defined as CPC 1-2, an unfavorable outcome as CPC 3-5. RESULTS: Both EEG-R and EMG-R were predictors for good outcome (EEG-R accuracy 72% (95%-CI 66-79), sensitivity 86% (78-93), specificity 60% (50-69); EMG-R accuracy 65% (58-72), sensitivity 61% (51-75), specificity 69% (60-78)). When reactivity was defined as EEG-R and/or EMG-R, the accuracy was 73% (67-70), the sensitivity 94% (90-99), and the specificity 53% (43-63). CONCLUSION: Taking EMG into account when assessing reactivity of EEG seems to reduce false negative predictions for identifying patients with favorable outcome after cardiac arrest.
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