Resuscitation
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Observational Study
Continuous surface EMG power reflects the metabolic cost of shivering during targeted temperature management after cardiac arrest.
Shivering may interfere with targeted temperature management (TTM) after cardiac arrest, contributing to secondary brain injury. Early identification of shivering is challenging with existing tools. We hypothesized that shivering detected by continuous surface sEMG monitoring would be validated with calorimetry and detected earlier than by intermittent clinical observation. ⋯ Shivering was detected by sEMG power earlier than by clinical assessment with BSAS, with similar accuracy compared to the indirect calorimetry gold standard. Continuous sEMG monitoring appears useful for clinical assessment and research for shivering during TTM.
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In patients after cardiac arrest (CA), EEG reactivity (EEG-R) is proposed as a prognostic marker. However, no clear guidelines exist on how to test EEG-R and definitions are unspecific. Therefore, we aimed at forming international consensus regarding a stimulus protocol for EEG-R testing and the interpretation of EEG-R in daily clinical care. ⋯ This international consensus statement on EEG-R in patients after CA can be regarded as starting point. At the moment evidence is limited and our study can provide best-practice guidance in patients after CA as well as other comatose patients.