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
Resuscitationjournal_title
Resuscitationauthors
Alvarez V,Reinsberger C,Scirica B,O'Brien MH,Avery KR,Henderson G,Lee JWdoi
10.1016/j.resuscitation.2015.06.006subject
Has Abstractpub_date
2015-08-01 00:00:00pages
128-35eissn
0300-9572issn
1873-1570pii
S0300-9572(15)00250-6journal_volume
93pub_type
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