Abstract 1782: Incidence of Seizures in Comatose Cardiac Arrest Survivors Undergoing Therapeutic Hypothermia
Introduction Hypoxic encephalopathy is one of the most devastating sequelae of cardiopulmonary arrest. Seizures have been associated to varying degrees with hypoxic encephalopathy following cardiac arrest. This preliminary investigation aims to describe the incidence of electroencephalographically (EEG) documented seizure activity in comatose patients who survived cardiac arrest and underwent therapeutic hypothermia.
Methods A retrospective review of all patients who survived in- and out-of-hospital cardiac arrest, remained in a comatose state, and received induced hypothermia therapy using the Arctic Sun ™ Temperature Management System from November 2004 through October 2005. Data was collected regarding patient demographics, pre- and post-arrest clinical status, cardiopulmonary arrest data, and clinical outcome defined by mortality or discharge to home or an extended care facility. Patients underwent electroencephalography to document presence of encephalopathy and/or seizure activity.
Results Thirty (30) subjects met inclusion criteria for therapeutic hypothermia. Twenty-eight (28) subjects had EEGs done within 48 hours from return of spontaneous circulation. Seizure activity was noted in 9 subjects (30%). Six (6) subjects were found to have EEGs consistent with status epilepticus. Due to a small sample size, seizure activity did not have a statistically significant relationship with clinical outcome following Chi-square analysis.
Conclusion This preliminary study found the incidence of seizures in cardiac arrest survivors undergoing therapeutic hypothermia to be much higher than initially expected. These seizures may contribute to poorer neurological outcome. Performing initial EEGs in comatose cardiac arrest survivors undergoing therapeutic hypothermia may be beneficial for early detection of post-anoxic seizures.