Maayke Hunfeld

49 Review neuromonitoring EEG classification EEG timing Results Mortality (%) Limitations EBM Grade -Continuous -Discontinuous -Reactivity: no, high voltage δ slower than 2 Hz or faster than 2 Hz Routine EEG daily day 1-3, first < 24 hrs post ROSC Together with SEP and BAEP (see EP table) -In children with uncertain prognosis at 24 hrs initial discontinuous EEG, spikes or epileptiform discharges are associated with unfavorable outcome (PPV 100%, sensitivity 27%, 54%) -Other factors predictive of unfavourable outcome (expressed in PPV): 1.CPR duration > 10 min, GCS < 5 after 24 hrs 2.Bilateral absence N20 wave (SEP) 45 % (children with uncertain prognosis) -Heterogeneous population (no subgroup analysis possible for CA) -Crude outcome 2B 1=Continuous, not low voltage, not slow 2= Continuous, low voltage or slow 3=Continuous, low voltage and slow 4=Discontinuous 5=Isoelectric Routine EEG < 7 days post ROSC. median 1 day (IQR 0-2 days -90% of pts with EEG scale of 4 or 5 had poor outcome -91% of pts with EEG scale of 1 or 2 had good outcome -EEG scale ≥ 2: PPV 53% NPV 100% EEG scale ≥ 3: PPV 73%, NPV 91% EEG scale ≥ 4: PPV 90%, NPV 65% EEG scale ≥ 5: PPV 100%,NPV 55% 41% -Retrospective -Only IHCA -EEG only if clinically indicated -Clinician not blinded for EEG results. -Different timing EEG -Short term and crude outcome -PCPC by chart review 2B 1= Normal for age 2=Attenuation/slowing 3=BS, excessive discontinuity Onset cEEG within 5 hrs for > 24 hrs 47% electrographic seizure 32% electrographic status epilepticus. 9 poor outcome (7 with severe EEG background abnormalities) 26% -Small cohort -Not focusing on outcome -Short term non defined follow up 2B 2