To assess the ability of amplitude-integrated electroencephalography monitoring
within 24 hours of the return of spontaneous circulation to prognosticate neurologic outcomes in children following cardiac arrest
Retrospective review of prospectively recorded data. An amplitude-integrated electroencephalography
background score was calculated according to background activity during the first 24 hours after return of spontaneous circulation, a higher score correlating with more impaired background activity. The primary endpoint was the neurologic outcome as defined by the Pediatric Cerebral Performance Category at PICU discharge (Pediatric Cerebral Performance Category 1–3: a good neurologic outcome; Pediatric Cerebral Performance Category 4–6: a poor neurologic outcome).
A referral PICU.
Thirty children with a median age of 10 months (2–38 mo) and a male/female sex ratio of 1.3 were included.
Measurements and Main Results:
Eighteen patients were assigned to the favorable outcome group and 12 to the unfavorable outcome group. The median time between return of spontaneous circulation and amplitude-integrated electroencephalography
initiation was 4 hours (3–9 hr). The amplitude-integrated electroencephalography
score within 24 hours after return of spontaneous circulation was significantly higher in the children with poor outcomes compared with those with good outcomes (12 ± 4 vs 25 ± 8; p
< 0.001). Background activity during amplitude-integrated electroencephalography monitoring
was able to predict poor neurologic outcomes at PICU discharge, with an area under the receiver operating characteristic curve of 0.91 (95% CI, 0.81–1.00).
Early amplitude-integrated electroencephalography monitoring
may help predict poor neurologic outcomes in children within 24 hours following cardiac arrest