Does continuous EEG influence prognosis in patients after cardiac arrest?. (November 2018)

• Record Type: Journal Article
• Authors: Fatuzzo, Daniela; Beuchat, Isabelle; Alvarez, Vincent; Novy, Jan; Oddo, Mauro; Rossetti, Andrea O.
• Is Part Of: Resuscitation. Volume 132(2018)
• Page Start: 29
• Page End: 32
• Publication Date: 2018-11
• Subjects: Routine EEG -- Monitoring -- Mortality -- Outcome; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2018.08.023
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Aim: 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. Methods: 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. Results: 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. Conclusions: Our data suggest that cEEG does not confer any advantage over intermittent rEEG regarding outcome in patients with CA, and does not influence the time to death.