Standardized EEG Analysis to Reduce the Uncertainty of Outcome Prognostication After Cardiac Arrest

link.springer.com February 21, 2020

In the majority of comatose cardiac arrest (CA) patients, the outcome remains indeterminate after application of ERC/ESICM prognostication algorithm. Standardized EEG background analysis enables accurate prediction of both good and poor recovery, thereby greatly reducing uncertainty about coma prognostication in this patient population.

Using the ERC/ESICM algorithm, 155 (32%) patients were prognosticated with poor outcome; all died at 3 months.

Among the remaining 330 (68%) patients with an indeterminate outcome, the majority (212/330; 64%) showed good recovery.

In this patient subgroup, absence of a highly malignant EEG by day 3 had 99.5 [97.4–99.9] % sensitivity for good recovery, which was superior to NSE < 33 μg/L. A prospective cohort of comatose CA patients was examined in whom the ERC/ESICM algorithm was applied.