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Electroencephalogram for prognosis after cardiac arrest.

Eyad A L Thenayan¹, Martin Savard, Michael D Sharpe

¹Department of Adult Critical Care Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Journal of Critical Care

|September 29, 2009

Summary

This summary is machine-generated.

Electroencephalogram (EEG) reactivity after cardiac arrest (CA) is a strong predictor of neurologic recovery. Non-reactive EEG patterns, especially suppression or epileptiform activity, indicate a poor prognosis for regaining awareness.

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Area of Science:

Neurology
Critical Care Medicine
Neurophysiology

Background:

Neurologic prognosis after cardiac arrest (CA) is crucial for patient management.
Current electroencephalogram (EEG) classifications (benign/malignant) may lack prognostic granularity.
The prognostic significance of EEG reactivity has not been fully explored.

Purpose of the Study:

To investigate the prognostic value of EEG reactivity in comatose patients post-CA.
To determine if EEG reactivity, alongside traditional classifications, improves outcome prediction.
To explore the significance of specific EEG patterns like suppression and epileptiform activity.

Main Methods:

Retrospective analysis of consecutive comatose adult patients with EEG recordings post-CA.
EEG recordings were obtained at least 1 day after CA or after mild hypothermia.
Outcomes were defined as recovery of awareness versus no recovery during hospitalization.

Main Results:

EEG reactivity demonstrated high sensitivity (90%) and specificity (94%) for predicting awareness recovery.
Of 11 reactive EEGs, 10 patients recovered awareness; of 18 non-reactive EEGs, only 1 recovered.
Suppression or generalized epileptiform activity without reactivity was universally associated with no awareness recovery.

Conclusions:

EEG reactivity is a significant favorable prognostic indicator following cardiac arrest.
Absence of EEG reactivity, particularly with suppression or epileptiform patterns, strongly predicts lack of neurologic recovery.
Incorporating EEG reactivity into prognostication enhances the accuracy of outcome prediction after CA.