Continuous electrodermal activity as a potential novel neurophysiological biomarker of prognosis after cardiac arrest--A pilot study.

Abstract:

AIMS:Neurological outcome prognosis remains challenging in patients undergoing therapeutic hypothermia (TH) after cardiac resuscitation. Technological advances allow for a novel wrist-worn device to continuously record electrodermal activity (EDA), a measure of pure sympathetic activity. METHODS:A prospective cohort study was performed to determine the yield of continuous EDA in patients treated with TH for coma after cardiac arrest during hypothermia and normothermia. Association between EDA parameters (event-related and nonspecific electrodermal responses (ER-EDR, NS-EDR)) and outcome measures (cerebral performance category [CPC]) (Full Outline in UnResponsivenss (FOUR) score) were assessed. RESULTS:Eighteen patients were enrolled. Total number of EDR (66.4 vs 12.0/24h, p = 0.02), ER-EDR (39.5 vs 11.2/24h, p = 0.009), median amplitude change of all EDR (0.08 vs 0.03 μSI, p = 0.03) and ER-EDR (0.14 vs 0.05 μSI, p = 0.025) were higher in patients with favorable (CPC 1-2) versus poor outcome (CPC 3-5) during hypothermia. Greater differences in EDA parameters were observed during hypothermia than normothermia. The FOUR score was correlated to the number of all EDR and median amplitudes. CONCLUSIONS:Continuous EDA potentially opens a new avenue for autonomic function monitoring in neurocritically ill patients. It is feasible in the ICU setting, even during hypothermic states. As a measure of a complete neurophysiological circuit, it may be a novel neurophysiologic biomarker of outcome after cardiac resuscitation.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Alvarez V,Reinsberger C,Scirica B,O'Brien MH,Avery KR,Henderson G,Lee JW

doi

10.1016/j.resuscitation.2015.06.006

subject

Has Abstract

pub_date

2015-08-01 00:00:00

pages

128-35

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(15)00250-6

journal_volume

93

pub_type

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