Added value of somato-sensory evoked potentials amplitude for prognostication after cardiac arrest
Resuscitation Feb 14, 2020
Barbella G, et al. - Researchers investigated the prognostic value of cortical somato-sensory evoked potentials (SSEPs) amplitude vs other known predictors for outcomes after cardiac arrest (CA). In a prospective CA registry, SSEP amplitudes were retrospectively reviewed, an amplitude cut-off for worst CPC within 3 months was identified, and correlations of SSEP amplitude with pupillary light reflex (PLR), myoclonus, peak serum neuron specific enolase (NSE), and 24–36 h and 36–72 h EEG (reactivity, epileptiform features) was examined. They assessed 158 patients; among these, 54% were awoken. EEG findings, present PLR, myoclonus, NSE were noted to be correlated with amplitudes. A cut-off for cortical SSEP ≤ 0.41 µV was 100% specific for poor outcome; sensitivity improved marginally vs SSEPs absence for CPC 5. The analysis revealed an association of decreased SSEPs amplitudes with poor outcomes after cardiac arrest; however, only a slight improvement was observed in prediction of mortality, but not of a poor or good outcome, when this is added to a multimodal prognostic approach including EEG, clinical and blood biomarkers.
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