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Badosa Gali E, Nunez Torras M, Aboal Vinas J, Pascual Mayans J, Kassem Perez H, Singh M, Brugada Terradellas R, Loma-Osorio Ricon P. Neurological evolution of patients in coma at 72 hours after out-of-hospital cardiac arrest. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Establishing neurological prognosis after out-of-hospital cardiac arrest (OHCA) safely and early in those patients who remain in a coma at 72 hours of admission.
Purpose
To analyze the prognostic performance of neuron-specific enolase (NSE), Somatosensory evoked potentials (SSEPs) and electroencephalogram (EEG) in these patients.
Methods
Prospective and observational study, including all OHCAs admitted to a Cardiovascular Intensive Care Unit (CICU) of a tertiary hospital. Neurological stratification was performed at 72 hours with NSE (poor prognosis >60 ng/mL), SSEP (poor prognosis in the absence of N20) and EEG (poor prognosis). The sensitivity and specificity of each test for poor prognosis were calculated, as well as the three tests together.
Results
Between 03/17/2013 and 02/24/2022, 422 OHCAs were registered, of which 170 patients remained in a coma at 72 hours. The EEG had a sensitivity of 84% and a specificity of 89% due to poor prognosis. SSEPs had a sensitivity of 68% and a specificity of 98% due to poor prognosis. The NSE had a sensitivity of 67% and a specificity of 100% due to poor prognosis. The three tests were able to be performed on 110 patients, the sensitivity for poor prognosis of the three combined tests was 49% and the specificity was 100%.
Conclusions
In patients in a coma at 72 hours of OHCA, the most specific test to establish a poor prognosis was SSEP and the most sensitive was EEG. The combination of the three had a specificity of 100%.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Badosa Gali
- University Hospital de Girona Dr. Josep Trueta , Girona , Spain
| | - M Nunez Torras
- University Hospital de Girona Dr. Josep Trueta , Girona , Spain
| | - J Aboal Vinas
- University Hospital de Girona Dr. Josep Trueta , Girona , Spain
| | | | - H Kassem Perez
- University Hospital de Girona Dr. Josep Trueta , Girona , Spain
| | - M Singh
- University Hospital de Girona Dr. Josep Trueta , Girona , Spain
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Llongueras Espi P, Pons Monne M, Salvans Cirera M, Graterol Torres F, Singh M, Ramos Polo R, Vinas Fernandez D, Kassem Perez H, Pascual Mayans J, Badosa Gali E, Nunez Torras M, Aboal Vinas J, Loma-Osorio Ricon P, Brugada Tarradellas R. Mobile versus fixed automated external defibrillators (AED deployment in a geographically dispersed population: analysis of the girona territori cardioprotegit project. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction/Aim
Public defibrillation doubles out-of-hospital cardiac arrest survival. However, the best way to provide public defibrillation coverage to geographically dispersed populations remains unknown. The aim of this study is to compare usage rates and effectivity between mobile versus fixed Automated External Defibrillators (AED).
Methods
This project is a prospective registry of the usage rate of public AED (542 fixed AED, 241 mobile AED) and the analysis of the electrocardiographic traces, from June 2011 until December 2019. We compared the usage rate, the proportion of shockable rhythms and defibrillation success between fixed versus mobile AED.
Results
Of 566 registered usages, we obtained 494 electrocardiographic traces, of which 108 (21%) were from fixed AED. The usage rate of fixed and mobile AED were 0.022use/AED-year and 0.177use/AED-year respectively. In Fixed AED group we observed a higher proportion of shockable rhythms (34.2% vs. 20.3%, p=0,01) and higher defibrillation success (79% vs. 63%, p=0,02). The proportion of patients with shockable rhythms who were transferred to a hospital were 62.1% and 50% in Fixed AED and Mobile AED group respectively (p=0,306).
Conclusions
In Fixed AED group we observed more shockable rhythms and higher defibrillation success rates. Mobile AED were 8 times more used.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
| | - M Pons Monne
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | | | | | - M Singh
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - R Ramos Polo
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | | | - H Kassem Perez
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | | | - E Badosa Gali
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - M Nunez Torras
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
| | - J Aboal Vinas
- University Hospital de Girona Dr. Josep Trueta, Girona, Spain
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