Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest

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Kortelainen , J , Ala-Kokko , T , Tiainen , M , Strbian , D , Rantanen , K , Laurila , J , Koskenkari , J , Kallio , M , Toppila , J , Väyrynen , E , Skrifvars , M B & Hästbacka , J 2021 , ' Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest ' , Resuscitation , vol. 165 , pp. 170-176 . https://doi.org/10.1016/j.resuscitation.2021.05.032

Title: Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest
Author: Kortelainen, Jukka; Ala-Kokko, Tero; Tiainen, Marjaana; Strbian, Daniel; Rantanen, Kirsi; Laurila, Jouko; Koskenkari, Juha; Kallio, Mika; Toppila, Jussi; Väyrynen, Eero; Skrifvars, Markus B.; Hästbacka, Johanna
Contributor organization: HUS Neurocenter
Neurologian yksikkö
Department of Neurosciences
HUS Internal Medicine and Rehabilitation
HUS Medical Imaging Center
Department of Diagnostics and Therapeutics
Kliinisen neurofysiologian yksikkö
HUS Diagnostic Center
University of Helsinki
HUS Emergency Medicine and Services
Helsinki University Hospital Area
Clinicum
HUS Perioperative, Intensive Care and Pain Medicine
Anestesiologian yksikkö
Date: 2021-08
Language: eng
Number of pages: 7
Belongs to series: Resuscitation
ISSN: 0300-9572
DOI: https://doi.org/10.1016/j.resuscitation.2021.05.032
URI: http://hdl.handle.net/10138/334414
Abstract: Aim of the study: EEG slow wave activity (SWA) has shown prognostic potential in post-resuscitation care. In this prospective study, we investigated the accuracy of continuously measured early SWA for prediction of the outcome in comatose cardiac arrest (CA) survivors. Methods: We recorded EEG with a disposable self-adhesive frontal electrode and wireless device continuously starting from ICU admission until 48 h from return of spontaneous circulation (ROSC) in comatose CA survivors sedated with propofol. We determined SWA by offline calculation of C-Trend (R) Index describing SWA as a score ranging from 0 to 100. The functional outcome was defined based on Cerebral Performance Category (CPC) at 6 months after the CA to either good (CPC 1-2) or poor (CPC 3-5). Results: Outcome at six months was good in 67 of the 93 patients. During the first 12 h after ROSC, the median C-Trend Index value was 38.8 (interquartile range 28.0-56.1) in patients with good outcome and 6.49 (3.01-18.2) in those with poor outcome showing significant difference (p < 0.001) at every hour between the groups. The index values of the first 12h predicted poor outcome with an area under curve of 0.86 (95% CI0.61-0.99). With a cutoff value of 20, the sensitivity was 83.3% (69.6%-92.3%) and specificity 94.7% (83.4%-99.7%) for categorization of outcome. Conclusion: EEG SWA measured with C-Trend Index during propofol sedation offers a promising practical approach for early bedside evaluation of recovery of brain function and prediction of outcome after CA.
Subject: Cardiac arrest
EEG
Hypoxic-Ischemic encephalopathy
Outcome
Prognostication
Propofol
THERAPEUTIC HYPOTHERMIA
PROGNOSTICATION
CARE
RESUSCITATION
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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