Guidelines for EEG Monitoring in Patients with Mild Therapeutic Hypothermic Treatment after Cardiac Arrest?

ABSTRACT

PURPOSE: Seizures can be detrimental to recovering brain in patients that are resuscitated after cardiac arrest. Early diagnosis and appropriate treatment of seizures may be important to improve prognosis. Therefore, we tried to determine factors that predict seizures and their characteristics in patients after cardiopulmonary resuscitation (CPR). METHODS: Sixty eight patients who were over 18 years of age and who presented at Chonnam National University hospital in a post-resuscitative state after cardiac arrest between April 2007 and April 2010 were enrolled. These patients were divided into two groups according to the development of seizure during hospitalization. Baselines characteristics, information related to cardiac arrest and CPR, results of laboratory tests, the method of treatment, and the neurologic state at discharge were collected. RESULTS: Twenty six patients experienced a seizure during hospitalization and it progressed to status epilepticus in 16 of them. The results of initial laboratory tests, baseline characteristics, and time variables related to CPR were not associated with the development of seizure. Half of seizures, with or without progression to status epilepticus, developed within 12 hours after return of spontaneous circulation. There was no significant difference in the two groups according to progression to status epilepticus. CONCLUSION: There are no predictable variables for development of seizures and progression to status epilepticus in patients after cardiac arrest. However, seizure usually occurs within 12 hours after the return of spontaneous circulation. The physician should consider these characteristics of seizures when he decides to use EEG monitoring to patients in a post-resuscitative state.