A Review of the Electrophysiological Neuroprognostications after Out of Hospital Cardiac Arrest

Abstract

This personal opinion review of the potential role for EEG in the multimodal neuroprognostication of comatose cardiac arrest patients, after resuscitation and targeted temperature management, discusses recent findings along with our personal experience from a large single-center cohort of 220 consecutive patients investigated with electrophysiological tests (EEG and SSEP). Although EEG has its limitations, along with all modalities in the multimodal prognostic framework, when timed appropriately and interpreted in a standardized fashion, it can be probabilistic but not deterministic of an individual patient’s neurological prognosis. The EEG phenotype can indicate both good and poor prognoses for a comatose patient on the Intensive Care Unit, which is a distinct advantage of this widely available modality, whilst an SSEP can reliably predict a poor outcome if absent and may also help predict good outcome using amplitude analysis.