Does continuous EEG influence prognosis in patients after cardiac arrest?

Resuscitation
Daniela FatuzzoAndrea O Rossetti

Abstract

Electroencephalography (EEG) is a key modality for assessment of prognosis following cardiac arrest (CA); however, whether continuous EEG (cEEG) is superior to routine intermittent EEG (rEEG) remains debated. We examined the impact of cEEG (>18 h) vs. rEEG (<30 min) on outcome in comatose CA patients as part of multimodal prognostication. We analysed a large prospective registry of comatose post-CA adults (n = 497; 2009-2018), stratified based on whether they received cEEG (n = 62) or rEEG (n = 435), including standardized reactivity testing at two time-points. The primary endpoint was the impact of cEEG vs. rEEG on Glasgow-Pittsburgh Cerebral Performance Categories (CPC) at three months; we also assessed impact on time to death. Main patients' baseline clinical characteristics and CPC scores were comparable between the EEG groups. By multivariable analysis age, non-shockable rhythm, presence of early myoclonus, absent EEG background reactivity, absent somato-sensory evoked potentials, and serum NSE were independently associated with poor neurological outcome (CPC 3-5), while the EEG approach had no impact on patient prognosis and time to death. Our data suggest that cEEG does not confer any advantage over intermittent rEEG reg...Continue Reading

Citations

Apr 26, 2019·Current Opinion in Critical Care·Tobias Cronberg
Apr 29, 2020·JAMA Network Open·Jonathan ElmerClifton W Callaway
Sep 12, 2020·Intensive Care Medicine·Claudio SandroniTobias Cronberg
Mar 6, 2021·Current Opinion in Neurology·Andrea O Rossetti, Vincent Alvarez
Jun 21, 2020·Lancet Neurology·Tobias CronbergAndrea O Rossetti
Apr 20, 2021·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Feng LiYida Hu
May 27, 2021·Clinical and Experimental Emergency Medicine·Young-Min KimUNKNOWN Steering Committee of 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Sep 13, 2020·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·A ComanducciM Massimini
Oct 8, 2021·Continuum : Lifelong Learning in Neurology·Eric S Rosenthal
Mar 11, 2021·Minerva anestesiologica·Andrea O Rossetti, Jong-Woo Lee

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