Abstract 53: Abnormal Continuous Electroencephalography Recordings Are Not Predictive of Survival Outcomes Following Cardiac Arrest
Background: Cerebral anoxia following cardiac arrest can lead to poor neurological outcomes. Post-arrest therapeutic hypothermia (TH) has been shown to be neuroprotective in this setting. Early prognostication of survival outcomes is important for patient care and resource management. The use of continuous electroencephalography (cEEG) may be an important tool for prognostication of survival outcomes after cardiac arrest.
Objectives: To determine if abnormal cEEG recordings are associated with survival outcomes following cardiac arrest.
Methods: Retrospective study of all patients who suffered an in- or out-of-hospital cardiac arrest and were entered into the post-arrest management protocol (PAMP) at a single academic institution between May 2011 and May 2012. As part of the PAMP, cEEGs are recorded during TH, during the rewarming phase, and at normothermia. All cEEG reports were assessed for routinely described abnormal patterns: severe suppression, burst suppression, status epilepticus, intermittent epileptiform discharges (IED), generalized periodic epileptiform discharges (GPED), either α,β, or [[Unable to Display Character: ▵]] coma, or diffuse intermixed slowing. Descriptive statistics were analyzed.
Results: Ninety-one patients were admitted to the ICU after cardiac arrest and 42 patients had PAMP and TH initiated. Of these, 36 (86%) received a neurologic consultation and 27(64%) had a cEEG placed. 24/27 (89%) survived to 24 hours and 7/27 (26%) survived to hospital discharge. Of the 7 survivors to discharge, 1 had severe suppression, 3 demonstrated α,β, or [[Unable to Display Character: ▵]] coma, and 3 demonstrated diffuse intermixed slowing during MTH. During early rewarming and normothermia, 3 had diffuse intermixed slowing, 2 demonstrated either α,β, or [[Unable to Display Character: ▵]] coma, and 1 demonstrated IEDs.
Conclusion: Abnormal cEEG during MTH and early rewarming is not predictive of survival outcomes following cardiac arrest in this small, retrospective study. This study is limited by the small number of enrolled patients who have completed the protocol to date.
- © 2012 by American Heart Association, Inc.