Abstract
Aims
We aimed to validate retrospectively the accuracy of simplified electroencephalography
(EEG) monitoring derived from the bispectral index (BIS) monitor in post-cardiac arrest
(CA) patients.
Methods
Successfully resuscitated CA patients were transferred to the Catherization Lab followed
by percutaneous coronary intervention when indicated. On arrival at the coronary care
unit, bilateral BIS monitoring was started and continued up to 72 h. Raw simplified
EEG tracings were extracted from the BIS monitor at a time point coinciding with the
registration of standard EEG monitoring. BIS EEG tracings were reviewed by two neurophysiologists,
who were asked to indicate the presence of following patterns: diffuse slowing rhythm,
burst suppression pattern, cerebral inactivity, periodic epileptiform discharges and
status epilepticus (SE). Additionally, these simplified BIS EEG tracings were analysed
by two inexperienced investigators, who were asked to indicate the presence of SE
only.
Results
Thirty-two simplified BIS EEG samples were analysed. Compared to standard EEG, neurophysiologists
interpreted all simplified EEG samples with a sensitivity of 86%, a specificity of
100% and an interobserver variability of 0.843. Furthermore, SE was identified with
a sensitivity of 80% and a specificity of 94% by two unexperienced physicians.
Conclusion
Using a simple classification system, raw simplified EEG derived from a BIS monitoring
device is comparable to standard EEG monitoring. Moreover, investigators without EEG
experience were capable to identify SE in post-CA patients. Future studies will be
warranted to confirm our results and to determine the added value of using simplified
BIS EEG in terms of prognostic and therapeutic implications.
Keywords
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Article info
Publication history
Published online: February 03, 2018
Accepted:
January 27,
2018
Received in revised form:
January 11,
2018
Received:
October 28,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
