University of Oulu

Jukka Kortelainen, Tero Ala-Kokko, Marjaana Tiainen, Daniel Strbian, Kirsi Rantanen, Jouko Laurila, Juha Koskenkari, Mika Kallio, Jussi Toppila, Eero Väyrynen, Markus B Skrifvars, Johanna Hästbacka, Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest, Resuscitation, Volume 165, 2021, Pages 170-176, ISSN 0300-9572, https://doi.org/10.1016/j.resuscitation.2021.05.032

Early recovery of frontal EEG slow wave activity during propofol sedation predicts outcome after cardiac arrest

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Author: Kortelainen, Jukka1,2; Ala-Kokko, Tero3,4; Tiainen, Marjaana5;
Organizations: 1Physiological Signal Analysis Team, Center for Machine Vision and Signal Analysis, MRC Oulu, University of Oulu, Oulu, Finland
2Cerenion Oy, Oulu, Finland
3Research Group of Surgery, Anaesthesiology and Intensive Care, Medical Faculty, University of Oulu, Oulu, Finland
4Division of Intensive Care Medicine, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
5Department of Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
6Department of Clinical Neurophysiology, MRC Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland
7Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Finland
8Department of Clinical Neurophysiology, HUS Diagnostics Center, Helsinki University Hospital, Helsinki, Finland
9Department of Clinical Neurosciences (Neurophysiology), University of Helsinki, Helsinki, Finland
10Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.1 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021110453722
Language: English
Published: Elsevier, 2021
Publish Date: 2021-11-04
Description:

Abstract

Aim of the study: EEG slow wave activity (SWA) has shown prognostic potential in post-resuscitation care. In this prospective study, we investigated the accuracy of continuously measured early SWA for prediction of the outcome in comatose cardiac arrest (CA) survivors.

Methods: We recorded EEG with a disposable self-adhesive frontal electrode and wireless device continuously starting from ICU admission until 48 h from return of spontaneous circulation (ROSC) in comatose CA survivors sedated with propofol. We determined SWA by offline calculation of C-Trend® Index describing SWA as a score ranging from 0 to 100. The functional outcome was defined based on Cerebral Performance Category (CPC) at 6 months after the CA to either good (CPC 1–2) or poor (CPC 3–5).

Results: Outcome at six months was good in 67 of the 93 patients. During the first 12 h after ROSC, the median C-Trend Index value was 38.8 (interquartile range 28.0–56.1) in patients with good outcome and 6.49 (3.01–18.2) in those with poor outcome showing significant difference (p < 0.001) at every hour between the groups. The index values of the first 12 h predicted poor outcome with an area under curve of 0.86 (95% CI 0.61−0.99). With a cutoff value of 20, the sensitivity was 83.3% (69.6%–92.3%) and specificity 94.7% (83.4%–99.7%) for categorization of outcome.

Conclusion: EEG SWA measured with C-Trend Index during propofol sedation offers a promising practical approach for early bedside evaluation of recovery of brain function and prediction of outcome after CA.

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Series: Resuscitation
ISSN: 0300-9572
ISSN-E: 1873-1570
ISSN-L: 0300-9572
Volume: 165
Pages: 170 - 176
DOI: 10.1016/j.resuscitation.2021.05.032
OADOI: https://oadoi.org/10.1016/j.resuscitation.2021.05.032
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
113 Computer and information sciences
217 Medical engineering
Subjects:
EEG
Funding: The study was funded by grant 308935 from Academy of Finland. The expert help of critical care study nurses Sinikka Sälkiö, Oulu University Hospital, Oulu, Finland and Tarja Suhonen, Helsinki University Hospital, Helsinki, Finland for data collection is highly appreciated.
Academy of Finland Grant Number: 308935
Detailed Information: 308935 (Academy of Finland Funding decision)
Copyright information: © 2021 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
  https://creativecommons.org/licenses/by/4.0/