Retrospective analysis of the prognostic value of electroencephalography patterns obtained in pediatric in-hospital cardiac arrest survivors during three years*

Nishisaki, Akira; Sullivan, Joseph; Steger, Bernhard; Bayer, Carey Roth; Dlugos, Dennis J.; Lin, Richard J.; Ichord, Rebecca; Helfaer, Mark A.; Nadkarni, Vinay

doi:10.1097/01.pcc.0000256621.63135.4b

Cited by 67 publications

(54 citation statements)

References 29 publications

(30 reference statements)

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“…In patients not treated with TH, some background features are known to have prognostic significance in adults 14 and children. 13,35,36 In adults, postanoxic status epilepticus is associated with worse outcome, with or without TH. 37 Further, at extremely low temperatures, as used in deep hypothermic circulatory arrest for vascular surgery, the EEG develops a discontinuous and then isoelectric pattern, but these severe EEG abnormalities are not seen with the moderate hypothermia temperatures used in TH.…”

Section: Figure Background Evolution and Seizure Occurrence By Subjectmentioning

confidence: 99%

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Abend¹,

Topjian²,

Ichord³

et al. 2009

Neurology

192

162

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Section: Figure Background Evolution and Seizure Occurrence By Subjectmentioning

confidence: 99%

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Abend¹,

Topjian²,

Ichord³

et al. 2009

Neurology

192

162

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“…As was reported in review articles by Young 1 , Markand 37 , Kaplan 2 and Nishisaki et al 38 the prognosis and the survival rate of patients submitted to emergency EEGs depends on the underlying disease. Hence, the main findings of emergency EEGs were capable of differentiating the different survival rates in the sample studied and is thus a good prognostic tool for patients attended in hospital emergency units.…”

Section: Resultsmentioning

confidence: 74%

Emergency EEG: study of survival

Borges

Botós

Bastos

et al. 2010

Arq. Neuro-Psiquiatr.

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Objective: To determine the survival rate according to the main findings of emergency electroencephalography (EEGs) of patients treated in a tertiary hospital. Method: In this prospective study, the findings of consecutive emergency EEGs performed on inpatients in Hospital de Base in São José do Rio Preto, Brazil were correlated with survival utilizing KaplanMeyer survival curves. results: A total of 681 patients with an average age of 42 years old (1 day to 96 years) were evaluated, of which 406 were male. The main reasons for EEGs were epileptic seizures (221 cases), hepatic encephalopathy [116 cases of which 85 (73.3%) were men, p-value=0.001], status epilepticus (104 cases) and impaired consciousness (78 cases). The underlying disease was confirmed in 578 (84.3%) cases with 119 (17.5%) having liver disease [91 (76.0%) were men, p-value=0.001], 105 (15.4%) suffering strokes, 67 (9.9%) having metabolic disorders, 51 (7.5%) central nervous system infections and 49 (7.2%) epilepsy. In the three months following EEG, a survival rate of 75% was found in patients with normal, discreet slow activity or intermittent rhythmic delta activity EEGs, of 50% for those with continuous delta activity and generalized epileptiform discharges, and of 25% for those with burst-suppression, diffuse depression, and in alpha/theta-pattern coma. Death was pronounced immediately in patients with isoelectric EEGs. conclusion: The main findings of EEGs, differentiated different survival rates and are thus a good prognostic tool for patients examined in emergencies. Key words: EEG, emergency, prognosis, probability of survival.EEG de urgência: taxa de sobrevivência rEsuMO Objetivo: Determinar a taxa de sobrevivência (TS), segundo os principais achados de eletrencefalograma de urgência (E-EEG), dos pacientes atendidos nas emergências de hospital de alta complexidade. Método: Estudo prospectivo, por ordem de chegada, da correlação entre os achados de E-EEG, feitos nos pacientes à beira do leito, com TS, utilizando-se as curvas de sobrevidas de Kaplan Meyer no Hospital de Base de São José do Rio Preto, São Paulo/Brasil. resultados: Foram estudados 681 pacientes, dos quais 406 (59,6%) masculinos, com idade média de 42 anos (1 dia a 96 anos). As principais motivações para o E-EEG foram crises epilépticas (221 casos), encefalopatia hepática [(116 casos, dos quais 85 masculinos (73,3%), p= 0,001]; estado de mal epiléptico 104 e rebaixamento de consciência 78. O diagnóstico da doença de base foi confirmado em 578 (84,3%), sendo 119 (17,5%) hepatopatia, dos quais 91 (76,%) masculinos, p= 0,001; 105 (15,4%) acidente vascular encefálico; 67 (9,9%) distúrbio metabólico; 51 (7,5%) infecção do sistema nervoso central e 49 (7,2%) epilepsia. TS de 75% nos três primeiros meses foi encontrada nos pacientes com

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“…For the important outcome of survival to hospital discharge, we identified very-low-quality evidence for prognostic significance (downgraded for imprecision and risk of bias, but with a moderate dose-response relationship) from 4 pediatric observational studies of IHCA and OHCA, 79,82,101,103 enrolling a total of 513 children showing that pupils reactive to light 12 to 24 hours after ROSC is associated with improved outcomes (RR, 2.3; 95% CI, 1.8-2.9).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Caen¹,

Maconochie²,

Aickin³

et al. 2015

Circulation

152

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The Pediatric Task Force reviewed all questions submitted by the International Liaison Committee on Resuscitation (ILCOR) member councils in 2010, reviewed all council training materials and resuscitation guidelines and algorithms, and conferred on recent areas of interest and controversy. We identified a few areas where there were key differences in council-specific guidelines based on historical recommendations, such as the A-B-C (Airway, Breathing, Circulation) versus C-A-B (Circulation, Airway, Breathing) sequence of provision of cardiopulmonary resuscitation (CPR), initial back blows versus abdominal thrusts for foreign-body airway obstruction, an upper limit for recommended chest compression rate, and initial defibrillation dose for shockable rhythms (2 versus 4 J/kg). We produced a working list of prioritized questions and topics, which was adjusted with the advent of new research evidence. This led to a prioritized palate of 21 PICO (population, intervention, comparator, outcome) questions for ILCOR task force focus.The 2015 process was supported by information specialists who performed in-depth systematic searches, liaising with pediatric content experts so that the most appropriate terms and outcomes and the most relevant publications were identified. Relevant adult literature was considered (extrapolated) in those PICO questions that overlapped with other task forces, or when there were insufficient pediatric data. In rare circumstances (in the absence of sufficient human data), appropriate animal studies were incorporated into reviews of the literature. However, these data were considered only when higher levels of evidence were not available and the topic was deemed critical.When formulating the PICO questions, the task force felt it important to evaluate patient outcomes that extend beyond return of spontaneous circulation (ROSC) or discharge from the pediatric intensive care unit (PICU). In recognition that the measures must have meaning, not only to clinicians but also to parents and caregivers, longer-term outcomes at 30 days, 60 days, 180 days, and 1 year with favorable neurologic status were included in the relevant PICO questions.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies 1 and using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) working group.2 After identifying and prioritizing the questions to be addressed (by using the PICO format) 3 with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk-of-bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnosti...

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Retrospective analysis of the prognostic value of electroencephalography patterns obtained in pediatric in-hospital cardiac arrest survivors during three years*

Abstract: In a single-center consecutive case series, electroencephalography background patterns during the initial 7 days after in-hospital cardiac arrest were associated with neurologic outcome in children.

Cited by 67 publications

References 29 publications

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Emergency EEG: study of survival

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

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