• Matteo Caporro, Andrea O Rossetti, Andrea Seiler, Thomas Kustermann, Nathalie A Nguepnjo Nguissi, Christian Pfeiffer, Rebekka Zimmermann, Matthias Haenggi, Mauro Oddo, Marzia De Lucia, and Frederic Zubler.
• Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland.
• Resuscitation. 2019 May 1; 138: 146-152.

AimTo assess whether stimulus-induced modifications of electromyographic activity observed on scalp EEG have a prognostic value in comatose patients after cardiac arrest.Methods184 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.ResultsBoth 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).ConclusionTaking EMG into account when assessing reactivity of EEG seems to reduce false negative predictions for identifying patients with favorable outcome after cardiac arrest.Copyright © 2019 Elsevier B.V. All rights reserved.

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