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Clinical review: Continuous and simplified electroencephalography to monitor brain recovery after cardiac arrest.

Friberg, Hans LU ; Westhall, Erik LU ; Rosén, Ingmar LU ; Rundgren, Malin LU ; Nielsen, Niklas LU and Cronberg, Tobias LU (2013) In Critical Care 17(4).
Abstract
There has been a dramatic change in hospital care of cardiac arrest survivors in recent years, including the use of target temperature management (hypothermia). Clinical signs of recovery or deterioration, which previously could be observed, are now concealed by sedation, analgesia, and muscle paralysis. Seizures are common after cardiac arrest, but few centers can offer high-quality electroencephalography (EEG) monitoring around the clock. This is due primarily to its complexity and lack of resources but also to uncertainty regarding the clinical value of monitoring EEG and of treating post-ischemic electrographic seizures. Thanks to technical advances in recent years, EEG monitoring has become more available. Large amounts of EEG data... (More)
There has been a dramatic change in hospital care of cardiac arrest survivors in recent years, including the use of target temperature management (hypothermia). Clinical signs of recovery or deterioration, which previously could be observed, are now concealed by sedation, analgesia, and muscle paralysis. Seizures are common after cardiac arrest, but few centers can offer high-quality electroencephalography (EEG) monitoring around the clock. This is due primarily to its complexity and lack of resources but also to uncertainty regarding the clinical value of monitoring EEG and of treating post-ischemic electrographic seizures. Thanks to technical advances in recent years, EEG monitoring has become more available. Large amounts of EEG data can be linked within a hospital or between neighboring hospitals for expert opinion. Continuous EEG (cEEG) monitoring provides dynamic information and can be used to assess the evolution of EEG patterns and to detect seizures. cEEG can be made more simple by reducing the number of electrodes and by adding trend analysis to the original EEG curves. In our version of simplified cEEG, we combine a reduced montage, displaying two channels of the original EEG, with amplitude-integrated EEG trend curves (aEEG). This is a convenient method to monitor cerebral function in comatose patients after cardiac arrest but has yet to be validated against the gold standard, a multichannel cEEG. We recently proposed a simplified system for interpreting EEG rhythms after cardiac arrest, defining four major EEG patterns. In this topical review, we will discuss cEEG to monitor brain function after cardiac arrest in general and how a simplified cEEG, with a reduced number of electrodes and trend analysis, may facilitate and improve care. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Critical Care
volume
17
issue
4
article number
233
publisher
BioMed Central (BMC)
external identifiers
  • pmid:23876221
  • wos:000331539700073
  • scopus:84880698610
  • pmid:23876221
ISSN
1364-8535
DOI
10.1186/cc12699
language
English
LU publication?
yes
id
eaff497c-7194-4351-8aa2-dabdde340cd4 (old id 3955684)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23876221?dopt=Abstract
date added to LUP
2016-04-01 10:26:23
date last changed
2022-01-25 23:14:59
@article{eaff497c-7194-4351-8aa2-dabdde340cd4,
  abstract     = {{There has been a dramatic change in hospital care of cardiac arrest survivors in recent years, including the use of target temperature management (hypothermia). Clinical signs of recovery or deterioration, which previously could be observed, are now concealed by sedation, analgesia, and muscle paralysis. Seizures are common after cardiac arrest, but few centers can offer high-quality electroencephalography (EEG) monitoring around the clock. This is due primarily to its complexity and lack of resources but also to uncertainty regarding the clinical value of monitoring EEG and of treating post-ischemic electrographic seizures. Thanks to technical advances in recent years, EEG monitoring has become more available. Large amounts of EEG data can be linked within a hospital or between neighboring hospitals for expert opinion. Continuous EEG (cEEG) monitoring provides dynamic information and can be used to assess the evolution of EEG patterns and to detect seizures. cEEG can be made more simple by reducing the number of electrodes and by adding trend analysis to the original EEG curves. In our version of simplified cEEG, we combine a reduced montage, displaying two channels of the original EEG, with amplitude-integrated EEG trend curves (aEEG). This is a convenient method to monitor cerebral function in comatose patients after cardiac arrest but has yet to be validated against the gold standard, a multichannel cEEG. We recently proposed a simplified system for interpreting EEG rhythms after cardiac arrest, defining four major EEG patterns. In this topical review, we will discuss cEEG to monitor brain function after cardiac arrest in general and how a simplified cEEG, with a reduced number of electrodes and trend analysis, may facilitate and improve care.}},
  author       = {{Friberg, Hans and Westhall, Erik and Rosén, Ingmar and Rundgren, Malin and Nielsen, Niklas and Cronberg, Tobias}},
  issn         = {{1364-8535}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Critical Care}},
  title        = {{Clinical review: Continuous and simplified electroencephalography to monitor brain recovery after cardiac arrest.}},
  url          = {{https://lup.lub.lu.se/search/files/1846034/4146436}},
  doi          = {{10.1186/cc12699}},
  volume       = {{17}},
  year         = {{2013}},
}