Early electroencephalographic findings correlate with neurological outcome in children following cardiac arrest

Abstract

Objective

To determine the clinical and electroencephalographic findings associated with prognosis in non-neonate children following cardiac arrest.

Design

Retrospective observational study.

Setting

Pediatric Intensive Care Unit and Cardiac Intensive Care Unit.

Patients

Non-neonate children with a history of cardiac arrest > 2 minutes and EEG monitoring within 72 hours of return of spontaneous circulation.

Measurements and Main Results

Clinical and features, neurophysiological data and Pediatric Cerebral Performance Category (PCPC) scores were collected. EEG traces were reviewed in a blinded manner, all seizures and EEG findings noted, and the EEG was scored at 1 hour, 24 hours and CEEG end. Discrete data regarding specific characteristics of the EEG background and seizures were studied. Univariate and multivariate analyses were performed to identify associations between clinical variables, EEG findings and PCPC score at hospital discharge. Multivariate analysis of 73 children revealed duration of cardiac arrest < 20 minutes or continuous EEG background activity within 12 hours post-ROSC were associated with good short term neurological outcome. Change in EEG background score over time and EEG data collected after the initial hour were not associated with outcome.

Conclusions

Following pediatric cardiac arrest, an initially normal EEG or generalized slowing of the EEG background was associated with good neurologic outcome at hospital discharge.