Electroencephalography during Out-of-hospital Cardiopulmonary Resuscitation

Nitzschke, Rainer; Schmidt, Günter

doi:10.1016/j.jemermed.2010.05.098

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…While results in animal models are promising [7,[32][33][34][35][36], literature data in humans are still controversial. Few studies suggested that BIS ™ or PSi values, and/or EEG analysis might reflect cerebral oxygenation [11,[17][18][19][20][21][22][23]; nevertheless, others showed that BIS ™ values, and EEG monitoring are not reliable indicator of cerebral function due to mechanical artifacts related to external chest compression and involuntary head movements [26]. Thus, after reviewing the literature, we have not found any convincing evidence suggesting standardized use of simplified EEG during CPR.…”

Section: Discussionmentioning

confidence: 66%

Electroencephalographic monitoring of brain activity during cardiac arrest: a narrative review

Roberti

Chiarini²,

Latronico³

et al. 2023

ICMx

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Background To date cardiac arrest (CA) remains a frequent cause of morbidity and mortality: despite advances in cardiopulmonary resuscitation (CPR), survival is still burdened by hypoxic–ischemic brain injury (HIBI), and poor neurological outcome, eventually leading to withdrawal of life sustaining treatment (WLST). The aim of CPR is cardiac pump support to preserve organ perfusion, until normal cardiac function is restored. However, clinical parameters of target organ end-perfusion during CPR, particularly brain perfusion, are still to be identified. In this context, electroencephalography (EEG) and its derivatives, such as processed EEG, could be used to assess brain function during CA. Objectives We aimed to review literature regarding the feasibility of EEG and processed or raw EEG monitoring during CPR. Methods A review of the available literature was performed and consisted of mostly case reports and observational studies in both humans and animals, for a total number of 22 relevant studies. Results The research strategy identified 22 unique articles. 4 observational studies were included and 6 animal testing studies in swine models. The remaining studies were case reports. Literature regarding this topic consists of conflicting results, containing studies where the feasibility of EEG during CPR was positive, and others where the authors reached opposite conclusions. Furthermore, the level of evidence, in general, remains low. Discussion EEG may represent a useful tool to assess CPR effectiveness. A multimodal approach including other non-invasive tools such as, quantitative infrared pupillometry and transcranial Doppler, could help to optimize the quality of resuscitation maneuvers.

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Section: Discussionmentioning

confidence: 66%

Electroencephalographic monitoring of brain activity during cardiac arrest: a narrative review

Roberti

Chiarini²,

Latronico³

et al. 2023

ICMx

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“…. In the case presentation involving two patients by Nitzschke et al, they argued that numerical processed parameters such as BIS and Patient State Index, derived during CPR based on EEG recordings, would be affected by artifacts from chest compressions, rendering them incapable of providing useful information regarding the adequacy of cerebral oxygenation during CPR(18). In Shibata et al's study, BIS monitoring was conducted on 10 patients admitted to the intensive care unit after experiencing sudden cardiac death with successful ROSC.…”

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confidence: 99%

Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research

ÖZDEMİR

2023

Eurasian Journal of Critical Care

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The current approach in cardiopulmonary resuscitation (CPR) involves interrupting the chest compressions to assess the pulse and diagnose Return of Spontaneous Circulation (ROSC). This critical step is essential for determining the effectiveness of resuscitation efforts. However, the interruption of CPR poses a challenge, prompting researchers to explore alternative methods for diagnosing ROSC without compromising the ongoing resuscitation process. One potential solution proposed in the literature is the use of the Bispectral Index (BIS). BIS is a numerical value derived from processed electroencephalogram data, providing a measure of the depth of anesthesia or sedation. Some studies have reported an increase in BIS values following successful ROSC during CPR. This observation suggests that monitoring BIS levels could offer real-time information about cerebral perfusion and neurological status, eliminating the need for pulse checks that require CPR interruption. Despite these promising indications, it is crucial to acknowledge the limited existing literature on the subject. The evidence supporting the use of BIS in diagnosing ROSC during CPR is not yet robust, and further research is warranted. Researchers are encouraged to delve into this unexplored area, conducting comprehensive studies to assess the reliability and effectiveness of BIS as a tool for continuous monitoring during resuscitation efforts. In conclusion, while the concept of using BIS to diagnose ROSC during CPR holds potential, it remains an area that requires substantial research attention. The limited existing literature underscores the need for more extensive investigations to determine the feasibility and reliability of integrating BIS into the CPR protocol. As technology advances, exploring innovative approaches for continuous assessment during resuscitation becomes imperative for improving outcomes in cardiac arrest scenarios

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The anesthesiologist and the EEG: Current uses and future trends in the operating room

Honorato‐Cia

Martínez-Simón

2019

Trends in Anaesthesia and Critical Care

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Electroencephalography during Out-of-hospital Cardiopulmonary Resuscitation

Cited by 3 publications

References 13 publications

Electroencephalographic monitoring of brain activity during cardiac arrest: a narrative review

Electroencephalographic monitoring of brain activity during cardiac arrest: a narrative review

Exploring the Role of Bispectral Index in Interrupting CPR for ROSC Diagnosis: A Call for Further Research

The anesthesiologist and the EEG: Current uses and future trends in the operating room

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