Cheng-I Wu1,2, Pai-Feng Hsu1,2,3, I-Hsin Lee4, Yenn-Jiang Lin1,2, Chun-Fu Lin5, Ju-Pin Pan1, Teh-Fu Hsu4, Chorng-Kuang How4, Shang-Yeong Kwan5, Fa-Po Chung1,2, Cheng-Hsueh Wu1,2, Shih-Ann Chen2,6. 1. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital. 2. Institute of Clinical Medicine, National Yang Ming Chiao Tung University. 3. Director of Coronary Care Unit. 4. Emergency Department. 5. Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei. 6. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
Abstract
BACKGROUND: Amplitude-integrated electroencephalography (aEEG) has been used as a tool to recognize brain activity in children with hypoxic encephalopathy. OBJECTIVES: To assess the prognostic value of aEEG during the post-resuscitation period of adult cardiogenic cardiac arrest, comatose survivors were monitored within 24 h of a return of spontaneous circulation using aEEG. METHODS: Forty-two consecutive patients experiencing cardiac arrest were retrospectively enrolled, and a return of spontaneous circulation was achieved in all cases. These patients were admitted to the Coronary Intensive Care Unit due to cardiogenic cardiac arrest. The primary outcome was the best neurologic outcome within 6 months after resuscitation, and the registered patients were divided into two groups based on the Cerebral Performance Category (CPC) scale (CPC 1-2, good neurologic function group; CPC 3-5, poor neurologic function group). All patients received an aEEG examination within 24 h after a return of spontaneous circulation, and the parameters and patterns of aEEG recordings were compared. RESULTS: Nineteen patients were in the good neurologic function group, and 23 were in the poor group. The four voltage parameters (minimum, maximum, span, average) of the aEEG recordings in the good neurologic function groups were significantly higher than in the poor group. Moreover, the continuous pattern, but not the status epilepticus or burst suppression patterns, could predict mid-term good neurologic function. CONCLUSIONS: aEEG can be used to predict neurologic outcomes based on the recordings' parameters and patterns in unconscious adults who have experienced a cardiac collapse, resuscitation, and return of spontaneous circulation.
BACKGROUND: Amplitude-integrated electroencephalography (aEEG) has been used as a tool to recognize brain activity in children with hypoxic encephalopathy. OBJECTIVES: To assess the prognostic value of aEEG during the post-resuscitation period of adult cardiogenic cardiac arrest, comatose survivors were monitored within 24 h of a return of spontaneous circulation using aEEG. METHODS: Forty-two consecutive patients experiencing cardiac arrest were retrospectively enrolled, and a return of spontaneous circulation was achieved in all cases. These patients were admitted to the Coronary Intensive Care Unit due to cardiogenic cardiac arrest. The primary outcome was the best neurologic outcome within 6 months after resuscitation, and the registered patients were divided into two groups based on the Cerebral Performance Category (CPC) scale (CPC 1-2, good neurologic function group; CPC 3-5, poor neurologic function group). All patients received an aEEG examination within 24 h after a return of spontaneous circulation, and the parameters and patterns of aEEG recordings were compared. RESULTS: Nineteen patients were in the good neurologic function group, and 23 were in the poor group. The four voltage parameters (minimum, maximum, span, average) of the aEEG recordings in the good neurologic function groups were significantly higher than in the poor group. Moreover, the continuous pattern, but not the status epilepticus or burst suppression patterns, could predict mid-term good neurologic function. CONCLUSIONS: aEEG can be used to predict neurologic outcomes based on the recordings' parameters and patterns in unconscious adults who have experienced a cardiac collapse, resuscitation, and return of spontaneous circulation.
Entities:
Keywords:
Amplitude-integrated electroencephalography; Cardiogenic cardiac arrest; Neuromonitoring; Resuscitation; Return of spontaneous circulation; Targeted temperature management
Authors: Sang Hoon Oh; Kyu Nam Park; Young Min Kim; Han Joon Kim; Chun Song Youn; Soo Hyun Kim; Seung Pill Choi; Seok Chan Kim; Young Min Shon Journal: Resuscitation Date: 2012-09-29 Impact factor: 5.262
Authors: Jeannette Hofmeijer; Tim M J Beernink; Frank H Bosch; Albertus Beishuizen; Marleen C Tjepkema-Cloostermans; Michel J A M van Putten Journal: Neurology Date: 2015-06-12 Impact factor: 9.910
Authors: Sang Hoon Oh; Kyu Nam Park; Young-Min Shon; Young-Min Kim; Han Joon Kim; Chun Song Youn; Soo Hyun Kim; Seung Pill Choi; Seok Chan Kim Journal: Circulation Date: 2015-08-12 Impact factor: 29.690