Continuous amplitude-integrated electroencephalogram predicts outcome in hypothermia-treated cardiac arrest patients.
(2010) In Critical Care Medicine Jul 1. p.1838-1844- Abstract
- OBJECTIVE:: To assess the prognostic value of continuous amplitude-integrated electroencephalogram in comatose survivors after cardiac arrest and treated with hypothermia. DESIGN:: Prospective observational study. SETTING:: General intensive care unit at a university hospital. PATIENTS:: Comatose patients after cardiac arrest and treated with hypothermia. INTERVENTIONS:: Patients were sedated and continuously monitored using an amplitude-integrated electroencephalogram. Monitoring was commenced on arrival in the intensive care unit and continued until recovery of consciousness, death, or 120 hrs after cardiac arrest. The amplitude-integrated electroencephalogram was interpreted together with the original electroencephalogram and analyzed... (More)
- OBJECTIVE:: To assess the prognostic value of continuous amplitude-integrated electroencephalogram in comatose survivors after cardiac arrest and treated with hypothermia. DESIGN:: Prospective observational study. SETTING:: General intensive care unit at a university hospital. PATIENTS:: Comatose patients after cardiac arrest and treated with hypothermia. INTERVENTIONS:: Patients were sedated and continuously monitored using an amplitude-integrated electroencephalogram. Monitoring was commenced on arrival in the intensive care unit and continued until recovery of consciousness, death, or 120 hrs after cardiac arrest. The amplitude-integrated electroencephalogram was interpreted together with the original electroencephalogram and analyzed without knowledge of the patient's clinical status. The amplitude-integrated electroencephalogram patterns at start of registration and at normothermia and the transitions of the amplitude-integrated electroencephalogram patterns over time were correlated to outcome. MEASUREMENTS AND MAIN RESULTS:: A total of 111 consecutive patients were assessed; 11 patients were not included because of technical reasons and five were excluded because of death before normothermia. Ninety-five patients remained; 57 (60%) eventually regained consciousness, of whom 49 (52%) lived an independent life at 6 months. Thirty-one patients (33%) at start of registration and 62 patients (65%) at normothermia had a continuous electroencephalogram pattern, and this was strongly associated with recovery of consciousness (29/31 [90%] and 54/62 [87%]). A suppression-burst pattern was always transient and patients with suppression-burst at any time remained in coma until death. An initial flat pattern was registered in 47 patients, but this had no prognostic value. Electrographic status epilepticus was a common finding (26/95 patients [27%]) and two types of electrographic status epilepticus were identified: one developed from suppression-burst and one developed from a continuous background. Two patients from the latter group regained consciousness. CONCLUSIONS:: Continuous amplitude-integrated electroencephalogram adds valuable early positive and negative prognostic information in comatose survivors after cardiac arrest. We identified two types of postanoxic electrographic status epilepticus, which is a novel finding with possible therapeutic implications. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1625900
- author
- Rundgren, Malin LU ; Westhall, Erik LU ; Cronberg, Tobias LU ; Rosén, Ingmar LU and Friberg, Hans LU
- organization
- publishing date
- 2010
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Critical Care Medicine
- volume
- Jul 1
- pages
- 1838 - 1844
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000281559500010
- pmid:20562694
- scopus:77956229378
- ISSN
- 1530-0293
- DOI
- 10.1097/CCM.0b013e3181eaa1e7
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Laboratory for Experimental Brain Research (013041000), Clinical Neurophysiology (013013001), Anaesthesiology and Intensive Care (013230022)
- id
- 08778c40-1ada-4a6a-bf4c-8772c1c758d2 (old id 1625900)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/20562694?dopt=Abstract
- date added to LUP
- 2016-04-04 09:35:55
- date last changed
- 2022-04-23 21:17:27
@article{08778c40-1ada-4a6a-bf4c-8772c1c758d2, abstract = {{OBJECTIVE:: To assess the prognostic value of continuous amplitude-integrated electroencephalogram in comatose survivors after cardiac arrest and treated with hypothermia. DESIGN:: Prospective observational study. SETTING:: General intensive care unit at a university hospital. PATIENTS:: Comatose patients after cardiac arrest and treated with hypothermia. INTERVENTIONS:: Patients were sedated and continuously monitored using an amplitude-integrated electroencephalogram. Monitoring was commenced on arrival in the intensive care unit and continued until recovery of consciousness, death, or 120 hrs after cardiac arrest. The amplitude-integrated electroencephalogram was interpreted together with the original electroencephalogram and analyzed without knowledge of the patient's clinical status. The amplitude-integrated electroencephalogram patterns at start of registration and at normothermia and the transitions of the amplitude-integrated electroencephalogram patterns over time were correlated to outcome. MEASUREMENTS AND MAIN RESULTS:: A total of 111 consecutive patients were assessed; 11 patients were not included because of technical reasons and five were excluded because of death before normothermia. Ninety-five patients remained; 57 (60%) eventually regained consciousness, of whom 49 (52%) lived an independent life at 6 months. Thirty-one patients (33%) at start of registration and 62 patients (65%) at normothermia had a continuous electroencephalogram pattern, and this was strongly associated with recovery of consciousness (29/31 [90%] and 54/62 [87%]). A suppression-burst pattern was always transient and patients with suppression-burst at any time remained in coma until death. An initial flat pattern was registered in 47 patients, but this had no prognostic value. Electrographic status epilepticus was a common finding (26/95 patients [27%]) and two types of electrographic status epilepticus were identified: one developed from suppression-burst and one developed from a continuous background. Two patients from the latter group regained consciousness. CONCLUSIONS:: Continuous amplitude-integrated electroencephalogram adds valuable early positive and negative prognostic information in comatose survivors after cardiac arrest. We identified two types of postanoxic electrographic status epilepticus, which is a novel finding with possible therapeutic implications.}}, author = {{Rundgren, Malin and Westhall, Erik and Cronberg, Tobias and Rosén, Ingmar and Friberg, Hans}}, issn = {{1530-0293}}, language = {{eng}}, pages = {{1838--1844}}, publisher = {{Lippincott Williams & Wilkins}}, series = {{Critical Care Medicine}}, title = {{Continuous amplitude-integrated electroencephalogram predicts outcome in hypothermia-treated cardiac arrest patients.}}, url = {{http://dx.doi.org/10.1097/CCM.0b013e3181eaa1e7}}, doi = {{10.1097/CCM.0b013e3181eaa1e7}}, volume = {{Jul 1}}, year = {{2010}}, }