Prognostication in Post Cardiac Arrest Patients Treated with Therapeutic Hypothermia

Palagiri, Ashok; Sadaka, Farid; Lakshmanan, Rekha

doi:10.5772/55496

Cited by 2 publications

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References 54 publications

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“…When brain damage occurs, it is released into the bloodstream and cerebrospinal uid due to disruption of the blood-brain barrier. 9 Electroencephalogram (EEG) is a bedside tool that has been used to evaluate the degree of coma and the severity of damage following cardiac arrest. 10 Many EEG patterns have been associated with poor functional outcomes; the most reliable are generalized suppression of <20 µV, burst suppression pattern with generalized epileptiform activity, and generalized periodic complexes on a at background.…”

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Evaluation of serum biomarkers and electroencephalogram to determine survival outcomes in pediatric post-cardiac arrest patients

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Shattah

Salaheldin

et al. 2021

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Background Cardiac arrest causes primary and secondary brain injuries. We aimed to evaluate the association between neuron-specific enolase (NSE), serum S-100B (S100B), electroencephalogram (EEG) patterns, and post-cardiac arrest outcomes, including arrest duration and survival, in pediatric patients. Methods This prospective observational study was conducted in the pediatric intensive care unit of our hospital from January 2017 to December 2019 and included 41 post-cardiac arrest patients with different etiologies who underwent EEG and serum sampling for NSE and S100B. The participants were aged 1 month to 18 years who experienced cardiac arrest and underwent cardiopulmonary resuscitation after a sustained return of spontaneous circulation for ≥48 hours. We excluded immunocompromised patients, those with neurological diseases, hematological malignancies or solid tumors, or a history of head trauma. Results Approximately 19.5% (n=8) of patients survived until hospital discharge. Convulsions and sepsis—observed in 21.9% (n=9) and 82.9% (n=34) of patients, respectively—were significantly associated with higher mortality (relative risk: 1.33 [95% CI=1.09–1.6] and 1.99 [95% CI=0.8–4.7], respectively). Serum NSE and S100B levels were not statistically associated with outcome (P=0.278 and 0.693, respectively). NSE levels were positively correlated with arrest duration. EEG patterns were significantly associated with outcome (P=0.01). Non-epileptogenic EEG activity was associated with the highest survival rate. No patient with burst suppression survived. Conclusion Post-cardiac arrest syndrome is a serious condition with a high mortality rate. Management of sepsis and convulsions affects prognosis. NSE and S100B have no benefit in survival evaluation. EEG is recommended for all post-cardiac arrest patients.

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