Clinical Outcome After a Reactive Hypothermic EEG Following Cardiac Arrest

Abstract

A discontinuous EEG and high serum NSE are associated with mortality after CA in patients with poor outcome despite a reactive hypothermic EEG. This suggests more severe cerebral damage, but not to higher extent of systemic disease.

Multimodal Outcome Prognostication After Cardiac Arrest and Targeted Temperature Management: Analysis at 36 °C

“…Our findings show high specificity of a first unreactive EEG background for predicting poor outcome at 36°C. Besides background amplitude (31,32), reactivity has been repeatedly described (10,12,(33)(34)(35); however, as opposed to this study, those description rely on patients treated with 33°C and the first EEG recorded during TTM is generally not included as a predictor in current recommendations (28,36). We acknowledge that lack of standardized stimulations (24) remains a relevant limitation.…”

EEG reactivity to pain in comatose patients: Importance of the stimulus type

“…Reactivity has been used relatively widely as a prognostic tool in comatose patients [4][5][6][7][8][9][10] and recent studies show divergent interrater agreements 17,18 ; it is crucial to test it in a reproducible manner to minimize false negative interpretations, which may have potentially devastating consequences. Nipples are rich in sensory receptors innervated by lateral and anterior cutaneous branches of the 3rd, 4th, and 5th intercostal nerves 19 ;…”

“…EEG background reactivity represents an interesting outcome predictor, especially in survivors after cardiac arrest (CA), but also in other diseases in which the clinical examination is limited by anaesthetics drugs or therapeutic hypothermia [4][5][6][7][8][9][10] . Reactivity is mostly defined as a reproducible change in cerebral EEG activity (amplitude or frequency), including attenuation 5,6 , but to the best of our knowledge there are no formal guidelines for its testing 11 .…”

Care pathways models and clinical outcomes in Disorders of consciousness

“…The difficulty to accept the situation for caregivers as well as the difficulty to define a clear prognosis could explain the negative (or the no evaluation) answer for this item of the questionnaire (DeVoe, Wallace, & Fryer, 2009;Dou, Gao, Lu, & Chang, 2014;Olding et al, 2016;Tsetsou, Oddo, & Rossetti, 2013 However, future studies are needed including a monitoring with standardized clinical scale scores and a larger sample than the one involved for this pilot research in order to compare different models.…”