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The prognostic value of continuous amplitude-integrated electroencephalogram applied immediately after return of spontaneous circulation in therapeutic hypothermia-treated cardiac arrest patients.

Abstract：

INTRODUCTION:The purpose of this study was to examine the prognostic value of continuous amplitude-integrated electroencephalogram (aEEG) applied immediately after return of spontaneous circulation (ROSC) in therapeutic hypothermia (TH)-treated cardiac arrest patients. METHODS:From September 2010 to August 2011, we prospectively studied comatose patients treated with TH after cardiac arrest who were monitored with aEEG. Monitoring at the forehead was applied as soon as possible after ROSC in the emergency department and continued until recovery of consciousness, death, or 72 h after ROSC. Neurological outcome was assessed with the Cerebral Performance Category (CPC) scale at hospital discharge, and good neurological outcome was defined as a CPC score of 1 or 2. RESULTS:A total of 55 TH-treated patients were included. Monitoring started at a median of 96 min after ROSC (interquartile range, 49-174). At discharge, 28 patients had a CPC of 1-2, and 27 patients had a CPC of 3-5. Seventeen patients had a continuous normal voltage (CNV) trace at the start of monitoring, and this voltage was strongly associated with a good outcome (16/17 [94.1%]; sensitivity and specificity of 57.1 and 96.3%, respectively). No development of a CNV trace within the recorded period accurately predicted a poor outcome (21/21 [100%]; sensitivity and specificity of 77.8 and 100%, respectively). CONCLUSIONS:An initial CNV trace in aEEG applied to forehead immediately after ROSC is a good early predictor of a good outcome in TH-treated cardiac arrest patients. Conversely, no development of a CNV trace within 72h is an accurate and reliable predictor of a poor outcome with a false-positive rate of 0%.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Oh SH,Park KN,Kim YM,Kim HJ,Youn CS,Kim SH,Choi SP,Kim SC,Shon YM

doi

10.1016/j.resuscitation.2012.09.031

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

200-5

issue

2

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(12)00820-9

journal_volume

84

pub_type

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