1. Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest
- Author
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Kortelainen, J. (Jukka), Ala-Kokko, T. (Tero), Tiainen, M. (Marjaana), Strbian, D. (Daniel), Rantanen, K. (Kirsi), Laurila, J. (Jouko), Koskenkari, J. (Juha), Kallio, M. (Mika), Toppila, J. (Jussi), Väyrynen, E. (Eero), Skrifvars, M. B. (Markus B.), Hästbacka, J. (Johanna), Kortelainen, J. (Jukka), Ala-Kokko, T. (Tero), Tiainen, M. (Marjaana), Strbian, D. (Daniel), Rantanen, K. (Kirsi), Laurila, J. (Jouko), Koskenkari, J. (Juha), Kallio, M. (Mika), Toppila, J. (Jussi), Väyrynen, E. (Eero), Skrifvars, M. B. (Markus B.), and Hästbacka, J. (Johanna)
- 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® 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 12 h predicted poor outcome with an area under curve of 0.86 (95% CI 0.61−0.99). 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.
- Published
- 2021