Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest

Hockaday, Judith M.; Potts, Frances; Epstein, Eve; Bonazzi, Anthony; Schwab, Robert S.

doi:10.1016/0013-4694(65)90075-1

Cited by 239 publications

(58 citation statements)

References 12 publications

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“…This electroencephalographic finding occurred in particular as a consequence of anesthetics (midazolam, fentanil and barbiturates) during the treatment of SE and of anoxia caused by cardiorespiratory arrest, although in this study there were some cases due to other serious lesions of the central nervous system such as head-brain injury and intra-parenchymatous hemorrhages. In respect to the dismal prognosis, the data reported here are similar to other publications 1,27 with only 15% surviving after the third month.…”

Section: Resultssupporting

confidence: 91%

Emergency EEG: study of survival

Borges

Botós

Bastos

et al. 2010

Arq. Neuro-Psiquiatr.

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Objective: To determine the survival rate according to the main findings of emergency electroencephalography (EEGs) of patients treated in a tertiary hospital. Method: In this prospective study, the findings of consecutive emergency EEGs performed on inpatients in Hospital de Base in São José do Rio Preto, Brazil were correlated with survival utilizing KaplanMeyer survival curves. results: A total of 681 patients with an average age of 42 years old (1 day to 96 years) were evaluated, of which 406 were male. The main reasons for EEGs were epileptic seizures (221 cases), hepatic encephalopathy [116 cases of which 85 (73.3%) were men, p-value=0.001], status epilepticus (104 cases) and impaired consciousness (78 cases). The underlying disease was confirmed in 578 (84.3%) cases with 119 (17.5%) having liver disease [91 (76.0%) were men, p-value=0.001], 105 (15.4%) suffering strokes, 67 (9.9%) having metabolic disorders, 51 (7.5%) central nervous system infections and 49 (7.2%) epilepsy. In the three months following EEG, a survival rate of 75% was found in patients with normal, discreet slow activity or intermittent rhythmic delta activity EEGs, of 50% for those with continuous delta activity and generalized epileptiform discharges, and of 25% for those with burst-suppression, diffuse depression, and in alpha/theta-pattern coma. Death was pronounced immediately in patients with isoelectric EEGs. conclusion: The main findings of EEGs, differentiated different survival rates and are thus a good prognostic tool for patients examined in emergencies. Key words: EEG, emergency, prognosis, probability of survival.EEG de urgência: taxa de sobrevivência rEsuMO Objetivo: Determinar a taxa de sobrevivência (TS), segundo os principais achados de eletrencefalograma de urgência (E-EEG), dos pacientes atendidos nas emergências de hospital de alta complexidade. Método: Estudo prospectivo, por ordem de chegada, da correlação entre os achados de E-EEG, feitos nos pacientes à beira do leito, com TS, utilizando-se as curvas de sobrevidas de Kaplan Meyer no Hospital de Base de São José do Rio Preto, São Paulo/Brasil. resultados: Foram estudados 681 pacientes, dos quais 406 (59,6%) masculinos, com idade média de 42 anos (1 dia a 96 anos). As principais motivações para o E-EEG foram crises epilépticas (221 casos), encefalopatia hepática [(116 casos, dos quais 85 masculinos (73,3%), p= 0,001]; estado de mal epiléptico 104 e rebaixamento de consciência 78. O diagnóstico da doença de base foi confirmado em 578 (84,3%), sendo 119 (17,5%) hepatopatia, dos quais 91 (76,%) masculinos, p= 0,001; 105 (15,4%) acidente vascular encefálico; 67 (9,9%) distúrbio metabólico; 51 (7,5%) infecção do sistema nervoso central e 49 (7,2%) epilepsia. TS de 75% nos três primeiros meses foi encontrada nos pacientes com

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Section: Resultssupporting

confidence: 91%

Emergency EEG: study of survival

Borges

Botós

Bastos

et al. 2010

Arq. Neuro-Psiquiatr.

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“…It has long been agreed that the duration of cerebral anoxia is most responsible for the clinical outcome (2,5). In clinical situations, however, the anoxic period is generally difficult to estimate.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of humancardiac arrest, an electric activity in EEG generally disappears within 15 seconds of asystole and the activity is restored following reanimation. Hockaday et al (5) first reported that an EEGis a highly reliable measure for the prognosis of patients in coma induced by cardiac arrest. Several groups have studied the usefulness of EEGin predicting postresuscitation outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Pain and auditory stimuli were applied during the EEGrecordings. The EEGswere scored in reference to increasing severity and were classified into five grades according to schemes proposed by Hockaday et al (5) and by ScolloLavizzari and Bassetti (7) with a slight modification: Grade I, dominant normal alpha-activity with or without theta-deltaactivity; Grade II, dominant theta-delta-activity with detectable normal alpha-activity; Grade III, theta-delta-activity without alpha-activity; Grade IV, (i) delta-activity of low voltage, possibly with short isoelectrie intervals, or (ii) dominant, monomorphic and non-reactive alpha-activity {viz., alpha coma), or (iii) periodic generalized phenomena with a very low voltage background activity; Grade V, flat to isoelectric EEG(below 10-20 jliV A 68-year-old woman, who had hypertrophic cardiomyopa- generalized periodic triphasic waves. thy, suffered from ventricular fibrillation at our ICU.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, the length of post-anoxic coma is not always reliable prognostic criteria. AnEEGis a sensitive indicator of cerebral ischemia (4), and several groups have attempted to correlate neurological outcomes with the patterns and frequency spectra of EEGafter the resuscitation (5)(6)(7)(8)(9). However, the prognostic relevance of EEGshas not been established.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic Value of Electroencephalogram(EEG) in Anoxic Encephalopathy after Cardiopulmonary Resuscitation: Relationship among Anoxic Period, EEG Grading and Outcome.

Yamashita

Morinaga²,

Ohgo

et al. 1995

Intern. Med.

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We studied the prognostic applicability of electroencephalograms (EEGs) of seventy-nine patients within 24 hours after successful cardiopulmonary resuscitation. The EEGswere classified into five grades according to a modified Hockaday's scale. The EEGs of grades I and II implied full recovery, while those of grade III gave a varied but generally unfavorable prognosis. Patients with grades IV and V EEGssurvived in a vegetative condition or died without awakening. Eighteen patients showed EEGwith periodic patterns, all of which led to a fatal or vegetative outcome. One case showed EEGs associated with periodic triphasic waves and repetitive sharp transients in the same record. Several cases showed EEGswith different periodic patterns in consecutive records.Weconclude that an EEGis a good indicator of patient prognosis after cardiopulmonary resuscitation. However, the clinical significance of morphological differences of various periodic patterns that can occur during an EEGremains to be established. (Internal Medicine 34: 71-76, 1995)

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The isoelectric electroencephalogram. Significance in establishing death in patients maintained on mechanical respirators

Kimura¹

1968

Archives of Internal Medicine

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Electroencephalographic changes in acute cerebral anoxia from cardiac or respiratory arrest

Cited by 239 publications

References 12 publications

Emergency EEG: study of survival

Emergency EEG: study of survival

Prognostic Value of Electroencephalogram(EEG) in Anoxic Encephalopathy after Cardiopulmonary Resuscitation: Relationship among Anoxic Period, EEG Grading and Outcome.

The isoelectric electroencephalogram. Significance in establishing death in patients maintained on mechanical respirators

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