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Standardized EEG in...
Standardized EEG interpretation accurately predicts prognosis after cardiac arrest
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- Westhall, Erik (author)
- Lund University,Lunds universitet,Klinisk neurofysiologi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Neurophysiology,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Rossetti, Andrea O. (author)
- University of Lausanne
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- Van Rootselaar, Anne Fleur (author)
- Academic Medical Center of University of Amsterdam (AMC)
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- Kjaer, Troels Wesenberg (author)
- Zealand University Hospital
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- Horn, Janneke (author)
- Academic Medical Center of University of Amsterdam (AMC)
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- Ullén, Susann (author)
- Skåne University Hospital
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- Friberg, Hans (author)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Nielsen, Niklas (author)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital
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- Rosén, Ingmar (author)
- Lund University,Lunds universitet,Klinisk neurofysiologi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Neurophysiology,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Aneman, Anders (author)
- Liverpool Hospital
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- Erlinge, David (author)
- Lund University,Lunds universitet,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Gasche, Yvan (author)
- Ludwig-Maximilian University of Munich
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- Hassager, Christian (author)
- Copenhagen University Hospital
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- Hovdenes, Jan (author)
- Oslo university hospital
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- Kjaergaard, Jesper (author)
- Copenhagen University Hospital
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- Kuiper, Michael (author)
- Medical Center Leeuwarden
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- Pellis, Tommaso (author)
- Santa Maria degli Angeli Hospital
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- Stammet, Pascal (author)
- Centre Hospitalier de Luxembourg
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- Wanscher, Michael (author)
- Copenhagen University Hospital
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- Wetterslev, Jørn (author)
- Copenhagen University Hospital
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- Wise, Matt P. (author)
- University Hospital of Wales
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- Cronberg, Tobias (author)
- Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine
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(creator_code:org_t)
- 2016
- 2016
- English 9 s.
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In: Neurology. - 0028-3878. ; 86:16, s. 1482-1490
- Related links:
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http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
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- Objective: To identify reliable predictors of outcome in comatose patients after cardiac arrest using a single routine EEG and standardized interpretation according to the terminology proposed by the American Clinical Neurophysiology Society. Methods: In this cohort study, 4 EEG specialists, blinded to outcome, evaluated prospectively recorded EEGs in the Target Temperature Management trial (TTM trial) that randomized patients to 33°C vs 36°C. Routine EEG was performed in patients still comatose after rewarming. EEGs were classified into highly malignant (suppression, suppression with periodic discharges, burst-suppression), malignant (periodic or rhythmic patterns, pathological or nonreactive background), and benign EEG (absence of malignant features). Poor outcome was defined as best Cerebral Performance Category score 3-5 until 180 days. Results: Eight TTM sites randomized 202 patients. EEGs were recorded in 103 patients at a median 77 hours after cardiac arrest; 37% had a highly malignant EEG and all had a poor outcome (specificity 100%, sensitivity 50%). Any malignant EEG feature had a low specificity to predict poor prognosis (48%) but if 2 malignant EEG features were present specificity increased to 96% (p <0.001). Specificity and sensitivity were not significantly affected by targeted temperature or sedation. A benign EEG was found in 1% of the patients with a poor outcome. Conclusions: Highly malignant EEG after rewarming reliably predicted poor outcome in half of patients without false predictions. An isolated finding of a single malignant feature did not predict poor outcome whereas a benign EEG was highly predictive of a good outcome.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
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Neurology
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- By the author/editor
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Westhall, Erik
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Rossetti, Andrea ...
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Van Rootselaar, ...
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Kjaer, Troels We ...
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Horn, Janneke
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Ullén, Susann
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Friberg, Hans
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Nielsen, Niklas
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Rosén, Ingmar
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Aneman, Anders
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Erlinge, David
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Gasche, Yvan
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Hassager, Christ ...
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Hovdenes, Jan
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Kjaergaard, Jesp ...
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Kuiper, Michael
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Pellis, Tommaso
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Stammet, Pascal
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Wanscher, Michae ...
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Wetterslev, Jørn
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Wise, Matt P.
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Cronberg, Tobias
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
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Neurology
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Lund University