Continuous versus routine EEG in patients after cardiac arrest

Urbano, M.M. Valentina; Alvarez, Vincent; Schindler, Kaspar; Rüegg, Stephan; Ben-Hamouda, Nawfel; Nový, Jan; Rossetti, Andrea O.

doi:10.1016/j.resuscitation.2022.05.017

Cited by 15 publications

(9 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, EEG background frequency, continuity, and reactivity (if performed during the recording) are readily assessable in rEEG [69]. Finally, detailed assessment of patients with HIE, representing more than one-quarter of the studied cohort, confirmed that clinical outcome was independent of EEG type also in this relevant subgroup [71]. These data support a valid prognostic use of EEG background in comatose HIE patients [29, 30, 72, 73], assessed over a relatively short time, in a repeated manner.…”

Section: Resultsmentioning

confidence: 96%

Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence

Fenter,

Rossetti,

Beuchat

2023

Eur Neurol

Self Cite

View full text Add to dashboard Cite

Background Electroencephalography has long been used to detect seizures in patients with disorders of consciousness. In recent years, there has been a drastically increased adoption of continuous EEG (cEEG) in the ICUs. Summary Despite the development of increasingly performant imaging techniques and several validated biomarkers, EEG remains central to clinicians in the intensive care unit, and is experiencing expanding indications. Not only does EEG allow seizure or status epilepticus detection, which in the ICU often present without clinical movements, but it is also central for the prognostic evaluation of comatose patients, especially after cardiac arrest, and for detecting delayed ischemia after subarachnoid hemorrhage. Around two decades ago, improvements of technical aspects of recording and storing EEG tracings have led into the era of continuous EEG (cEEG) and automated quantitative analysis (qEEG). Given resources necessary to record and interpret cEEG, this is still not available in every center and widespread recommendations to use continuous instead of routine EEG (typically lasting 20 minutes) are still a matter of debate. In light of recent literature and personal experience, this review offers a rationale to address this question. Key message As compared to repeated rEEG, cEEG in comatose patients does not seem to improve clinical prognosis to a relevant extent, despite allowing a more performant detection ictal events and consequent therapeutic modifications. The choice between cEEG and rEEG must therefore always be patient tailored.

show abstract

Section: Resultsmentioning

confidence: 96%

Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence

Fenter,

Rossetti,

Beuchat

2023

Eur Neurol

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a randomized trial on adult patients without already proven ictal events, however, clinical outcome was not influenced by EEG duration [55 ▪ ], probably since the underlying biological background may prove more relevant in terms of prognostication than identification and treatment of repetitive epileptiform transients. This also applied to patients after cardiac arrest [59]. Continuous EEG is related to higher costs than routine EEG, requiring more recording machines and personnel (particularly readers) for a given setting.…”

Section: Electroencephalogram In Critically Ill Patientsmentioning

confidence: 99%

Recent advances in clinical electroencephalography

Frauscher,

Rossetti,

Beniczky

2024

Current Opinion in Neurology

Self Cite

View full text Add to dashboard Cite

Purpose of review Clinical electroencephalography (EEG) is a conservative medical field. This explains likely the significant gap between clinical practice and new research developments. This narrative review discusses possible causes of this discrepancy and how to circumvent them. More specifically, we summarize recent advances in three applications of clinical EEG: source imaging (ESI), high-frequency oscillations (HFOs) and EEG in critically ill patients. Recent findings Recently published studies on ESI provide further evidence for the accuracy and clinical utility of this method in the multimodal presurgical evaluation of patients with drug-resistant focal epilepsy, and opened new possibilities for further improvement of the accuracy. HFOs have received much attention as a novel biomarker in epilepsy. However, recent studies questioned their clinical utility at the level of individual patients. We discuss the impediments, show up possible solutions and highlight the perspectives of future research in this field. EEG in the ICU has been one of the major driving forces in the development of clinical EEG. We review the achievements and the limitations in this field. Summary This review will promote clinical implementation of recent advances in EEG, in the fields of ESI, HFOs and EEG in the intensive care.

show abstract

“…Full-montage routine EEG for 20–30 min is most commonly used after HIBI [10] and is available during office hours at most hospitals. Continuous EEG monitoring facilitates assessment of the EEG evolution after ROSC and increases sensitivity for seizure detection compared with routine EEG [11], but there is no evidence that it improves outcome prediction compared with intermittent EEG [12].…”

Section: Monitoring Electrical Cerebral Activitymentioning

confidence: 99%

Brain monitoring after cardiac arrest

Sandroni

Skrifvars

Taccone

2023

Current Opinion in Critical Care

View full text Add to dashboard Cite

Purpose of reviewTo describe the available neuromonitoring tools in patients who are comatose after resuscitation from cardiac arrest because of hypoxic–ischemic brain injury (HIBI).Recent findingsElectroencephalogram (EEG) is useful for detecting seizures and guiding antiepileptic treatment. Moreover, specific EEG patterns accurately identify patients with irreversible HIBI. Cerebral blood flow (CBF) decreases in HIBI, and a greater decrease with no CBF recovery indicates poor outcome. The CBF autoregulation curve is narrowed and right-shifted in some HIBI patients, most of whom have poor outcome. Parameters derived from near-infrared spectroscopy (NIRS), intracranial pressure (ICP) and transcranial Doppler (TCD), together with brain tissue oxygenation, are under investigation as tools to optimize CBF in patients with HIBI and altered autoregulation. Blood levels of brain biomarkers and their trend over time are used to assess the severity of HIBI in both the research and clinical setting, and to predict the outcome of postcardiac arrest coma. Neuron-specific enolase (NSE) is recommended as a prognostic tool for HIBI in the current postresuscitation guidelines, but other potentially more accurate biomarkers, such as neurofilament light chain (NfL) are under investigation.SummaryNeuromonitoring provides essential information to detect complications, individualize treatment and predict prognosis in patients with HIBI.

show abstract

Continuous versus routine EEG in patients after cardiac arrest

Cited by 15 publications

References 49 publications

Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence

Continuous versus Routine Electroencephalography in the Intensive Care Unit: A Review of Current Evidence

Recent advances in clinical electroencephalography

Brain monitoring after cardiac arrest

Contact Info

Product

Resources

About