Delayed Deterioration of EEG Background Rhythm Post-cardiac Arrest
Tadeu A Fantaneanu1, Rani Sarkis1, Kathleen Avery2
1Department of Neurology, Brigham and Women's Hospital, 75 Francis St, Boston, MA, 02115, USA.
Neurocritical Care
|December 23, 2016
Summary
Delayed EEG deterioration in cardiac arrest survivors after therapeutic hypothermia indicates poor outcomes. Early identification of this EEG pattern is crucial for potential interventions and improved prognoses.
Area of Science:
- Neurology
- Critical Care Medicine
- Cardiology
Background:
- Electroencephalogram (EEG) background continuity predicts favorable prognosis in cardiac arrest patients post-therapeutic hypothermia.
- A subset of patients exhibit delayed EEG deterioration, invariably leading to poor outcomes.
- Characterizing this delayed deterioration phenomenon is critical for understanding patient prognoses.
Purpose of the Study:
- To characterize the phenomenon of delayed EEG deterioration in cardiac arrest patients treated with therapeutic hypothermia.
- To identify the prognostic significance of delayed EEG deterioration.
Main Methods:
- Prospective cohort study of consecutive cardiac arrest patients undergoing therapeutic hypothermia (July 2012 - May 2015).
- Identification of patients with initially favorable EEG rhythms post-cooling.
- Characterization of a subset experiencing delayed EEG deterioration.
Main Results:
- 133 patients analyzed; 51.9% (69/133) had initially favorable EEGs.
- 10.1% (7/69) of patients with initially favorable EEGs showed subsequent deterioration.
- Delayed EEG deterioration was significantly associated with poor clinical outcomes, with a median time to deterioration of 55 hours.
Conclusions:
- Delayed EEG deterioration following therapeutic hypothermia is a marker of poor clinical outcomes.
- The underlying mechanism is hypothesized to be delayed neuronal degeneration, requiring further investigation.
- Identifying patients with delayed EEG deterioration is crucial for exploring interventions to potentially salvage outcomes.
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