Abstract
Introduction
Standardized EEG patterns according to the American Clinical Neurophysiology Society
(ACNS) (“highly malignant”, “malignant” and “benign”) demonstrated good correlation
with outcome after cardiac arrest (CA). However, this approach relates to EEGs after
target temperature management (TTM), and correlation to other recognized outcome predictors
remains unknown.
Objectives
To investigate the relationship between categorized EEG and other outcome predictors,
during and after TTM, at different temperatures.
Methods
In a prospective adult CA registry between 01.2014 and 06.2017, EEG at day one and
two after CA were reclassified into pre-defined categories. Correlations between EEG
and clinical, biochemical, neurophysiological outcome predictors, and prognosis (CPC
at three months; good: 1–2), were assessed.
Results
Of 203 CA episodes, 31.5% were managed targeting 33 °C, 60.6% targeting 36 °C, and
7.9% with spontaneous temperature. “Highly malignant” EEG was found in 36.7% of patients
at day one (predicting poor prognosis with 91% specificity −95%CI: 83%–97%-, and 63%
sensitivity −95% CI: 53%–72%), and 27.1% at day two. “Benign” EEG occurred in 19.2%
at day one (sensitivity to good prognosis: 35% −95%CI: 26%–46%-, positive predictive
value: 89% −95% CI: 75%–97%), and in 33.2% at day two. Categorized EEG showed robust
correlations with all prognostic predictors. Results were similar between EEGs recorded
at day one or two, and, especially for poor prognosis, across TTM targets.
Discussion
Standardized EEG categorization after CA shows strong correlation with other outcome
predictors, without marked variation across EEG recording time or TTM targets, underscoring
its prognostic role in a multimodal approach.
Keywords
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Article info
Publication history
Published online: March 09, 2018
Accepted:
March 8,
2018
Received in revised form:
February 20,
2018
Received:
December 22,
2017
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
