EXPERTS’ OPINION   Free access

Minerva Anestesiologica 2021 June;87(6):704-13

DOI: 10.23736/S0375-9393.21.14793-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

A matter of timing: EEG monitoring for neurological prognostication after cardiac arrest in the era of targeted temperature management

Darya KHAZANOVA ^{1, 2}, Vanja C. DOUGLAS ¹, Edilberto AMORIM ^{1, 2} ✉

¹ Department of Neurology, University of California, San Francisco, CA, USA; ² Division of Neurology, Zuckerberg San Francisco General Hospital, San Francisco, CA, USA

Neuromonitoring with electroencephalography (EEG) is an essential tool in neurological prognostication post-cardiac arrest. EEG allows reliable and real-time assessment of early changes in background patterns, development of seizures and epileptiform activity, as well as testing for background reactivity to stimuli despite use of sedation or targeted temperature management. Delayed emergence of consciousness post-cardiac arrest is common, therefore longitudinal monitoring of EEG allows the detection of trends indicative of neurological improvement before coma recovery can be observed clinically. In this review, we summarize essential recent literature in EEG monitoring for neurological prognostication post-cardiac arrest in the context of targeted temperature management, with a particular focus on the importance of the evolution of EEG patterns in the first few days following resuscitation.

KEY WORDS: Heart arrest; Electroencephalography; Coma