Continuous electroencephalogram patterns are suggestive of eventual neurologic outcomes in post-cardiac arrest patients treated with therapeutic hypothermia

Dermot Maher, Huy Tran, Miriam A Nuno, Dawn Eliashiv, Taizoon Yusufali, Nicholas D'Attellis, Jeffrey Chung

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Introduction: Therapeutic hypothermia (TH) after cardiac arrest (CA) resuscitation is the first therapy proven to increase survival to discharge and neurologic recovery. Methods for neurologic and mortality prognostication after CA resuscitation have been called into question because they were developed based on evidence that was developed prior to the advent of TH. This study examines the relationship between electroencephalogram (EEG) patterns and mortality and neurologic outcomes in post-CA patients undergoing TH. Methods: Eighty-three of 732 patients who had continuous EEG (cEEG) monitoring during TH were included. Continuous EEG tracings were classified as isoelectric, low voltage, burst suppression, epileptic form, and diffuse slowing. Primary outcomes are survival to discharge and Cerebral Performance Categories (CPCs) at hospital discharge. Results: Among patients with favorable neurologic outcomes (CPC1 and CPC2), the duration cardiopulmonary resuscitation and time until return of spontaneous circulation were shorter than observed in patients with poorer neurologic outcomes (CPC3, CPC4, and CPC5). The time to target temperature was equivalent among neurologic outcome groups (499.5 minutes vs 431.0 minutes, P = .09). Favorable neurologic outcome was associated with initial presentation with ventricular tachycardia or ventricular fibrillation and had cEEG patterns suggestive of diffuse slowing and epileptiform waves. Discussion: The use of cEEG can provide prognostication information otherwise not obtainable by clinical examination. Specific cEEG patterns predicted probability of mortality for patients according to their initial rhythm of CA as a function of cardiopulmonary resuscitation time.

Original languageEnglish (US)
Pages (from-to)121-125
Number of pages5
JournalJournal of Critical Care
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Induced Hypothermia
Heart Arrest
Nervous System
Electroencephalography
Cardiopulmonary Resuscitation
Resuscitation
Mortality
Survival
Ventricular Fibrillation
Ventricular Tachycardia
Temperature

Keywords

  • Cardiac arrest
  • Continuous electroencephalogram
  • Therapeutic hypothermia

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Continuous electroencephalogram patterns are suggestive of eventual neurologic outcomes in post-cardiac arrest patients treated with therapeutic hypothermia. / Maher, Dermot; Tran, Huy; Nuno, Miriam A; Eliashiv, Dawn; Yusufali, Taizoon; D'Attellis, Nicholas; Chung, Jeffrey.

In: Journal of Critical Care, Vol. 30, No. 1, 01.01.2015, p. 121-125.

Research output: Contribution to journalArticle

Maher, Dermot ; Tran, Huy ; Nuno, Miriam A ; Eliashiv, Dawn ; Yusufali, Taizoon ; D'Attellis, Nicholas ; Chung, Jeffrey. / Continuous electroencephalogram patterns are suggestive of eventual neurologic outcomes in post-cardiac arrest patients treated with therapeutic hypothermia. In: Journal of Critical Care. 2015 ; Vol. 30, No. 1. pp. 121-125.
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