Maayke Hunfeld

Review neuromonitoring EEG classification EEG timing Results Mortality (%) Limitations EBM Grade 1=Continuous/reactive 2=Continuous but unreactive 3=Discontinuous tracing, BS, or low voltage Onset cEEG: mean 9.3±0.3hrs post ROSC for > 24 hrs -PPV for poor outcome of EEG score of 2/3 during hypothermia 88% (95%CI 77-98%) -PPV for poor outcome of EEG score of 2/3 during normothermia 91% (95%CI 81-100%). -Continuous but unreactive EEG, discontinuous EEG, BS or no cerebral activity during hypothermia and rewarming were far more likely to have a poor outcome -All deaths in EEG categories 2 or 3 37% -Small cohort -Non blinded physicians -Seizures not evaluated in prognostication. -N=1 with discontinuous EEG good outcome -N=1 with normal EEG poor outcome -Only short and crude outcome -N=9 had pre-CA neurological abnormalities 2B 1=No seizures 2=Electrographic seizures 3=Electrographic status epilepticus cEEG in pts with acute encephalopathy at least 24 hrs up to 72 hrs (in pts with therapeutic hypothermia). In pts with NCSE until 24hrs after last ES. Of 50 HIE pts: -64% no seizures, 20% electrographic seizures, 16% electrographic status epilepticus -electrographic status epilepticus in children with acute encephalopathy including HIE is associated with mortality and worse short term outcome (OR resp 5.1, P 0.01, 17.3 (P<0.001) 18% (total cohort) -Unclear howmany pts CA -Unclear relation with EEG findings and outcome in pts after CA. -cEEG only when clinically indicated -Only short en crude outcome -Differences in use of anticonvulsants in pts with seizures 2B - EEG phase synchrony - Spatio-temporal variability - Electrode location analysis Routine EEG Timing unclear, dependent on treating physician -Poor outcome (vs good outcome): 1.higher magnitude phase synchrony (R-index), lower spatial complexity and temporal variability 2.frontal and parietal EEG electrodes show less spatial complexity (at 15 Hz) 36% (total cohort) -Retrospective -EEG findings and outcome not specified for pts after CA, but for total cohort -Different timing EEG -only short and crude outcome -Influence of Rx (heterogeneity) led to choice of band widths 3 and 15 Hz 2B 2