脑电图被认为是心脏骤停（CA）后昏迷患者预后不良的指南，但与良好预后相关的因素也越来越多地被描述。虽然已知纺锤形脑电图活动预示着危重患者的良好预后，但其在 CA 中的发生受到的关注有限，主要是在儿科队列中。我们假设这一特征与成人的良好结果有关。在前瞻性机构登记处 (09.2021-09.2023) 中对 CA 后昏迷成人的回顾性评估。使用 2x2 表和比例比较来测试早期（12-36 小时）和晚期（36-72 小时）常规脑电图前瞻性记录的纺锤样活动，并比较有利结果的可能性（3 个月时的 CPC 1-2） ，包括与现有良性脑电图描述的组合（Westhall：无恶性或高度恶性特征；修改：允许背景不连续、低电压、逆发展）。纺锤体与 24-48 小时血清神经元特异性烯醇化酶 (NSE) 峰值相关，作为神经元损伤的标志。在 276 名患者中，其中 66 名 (23.9%) 检测到纺锤体样活动，在早期脑电图中更常见。虽然单独而言，72 小时内检测到的这一特征对 CPC 1-2 (82.2%) 显示出高特异性和低敏感性 (36.8%)，但其添加显着提高了改良良性 EEG 的敏感性（从 90.5% 提高到 95.8%；p< 0.001；特异性为 54.4%）。具有纺锤样活动的患者的 NSE 显着较低（中位数 25.7，四分位间距 16.1-24.4，对比 39.4 µg/l，四分位间距 21.1-95.1；p<0.001）。纺锤样 EEG 活动可能有助于预测有利的结果在成人 CA 后患者中，并与较低的神经元损伤相关。版权所有 © 2024 作者。由 Elsevier B.V. 出版。保留所有权利。

EEG is considered in guidelines for poor outcome prognostication in comatose patients after cardiac arrest (CA), but elements related to favorable prognosis have also been increasingly described. While spindle EEG activity is known to herald good outcome in critically ill patients, its occurrence in CA has received limited attention, essentially in pediatric cohorts. We postulated that this feature is related to favorable outcome in adults.Retrospective assessment of comatose adults following CA in a prospective institutional registry (09.2021-09.2023). Spindle-like activity, noted prospectively on early (12-36 h) and late (36-72 h) routine EEGs, was tested using 2x2 tables and comparisons of proportions for the likelihood of favorable outcome (CPC 1-2 at 3 months), including combinations with existing benign EEG descriptions (Westhall: no malignant or highly malignant features; modified: allowing background discontinuity, low voltage, inverse development). Spindles were correlated with peak serum neuron-specific enolase (NSE) at 24-48 h as a marker of neuronal damage.Among 276 patients, spindle-like activity was detected in 66 (23.9 %) of them, more often in early EEGs. While, in isolation, this feature detected within 72 h showed high specificity for CPC 1-2 (82.2 %) and low sensitivity (36.8 %), its addition significantly enhanced sensitivity of modified benign EEG (from 90.5 % to 95.8 %; p < 0.001; specificity at 54.4 %). Patients with spindle-like activity had significantly lower NSE (median 25.7, interquartile range 16.1-24.4, vs. 39.4 µg/l, interquartile range 21.1-95.1; p < 0.001).Spindle-like EEG activity may orient on prognostication of favorable outcome in adult post CA patients, and correlates with lower neuronal damage.Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.