Continuous versus routine EEG in patients after cardiac arrest - Analysis of a randomized controlled trial (CERTA)

Details

Serval ID
serval:BIB_913128F149BF
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Continuous versus routine EEG in patients after cardiac arrest - Analysis of a randomized controlled trial (CERTA)
Journal
Resuscitation
Author(s)
Urbano V., Alvarez V., Schindler K., Rüegg S., Ben-Hamouda N., Novy J., Rossetti A. O.
ISSN
0300-9572
Publication state
Published
Issued date
30/05/2022
Peer-reviewed
Oui
Volume
176
Number
July
Pages
67-73
Language
english
Abstract
Background
Electroencephalography (EEG) is essential to assess prognosis in patients after cardiac arrest (CA). Use of continuous EEG (cEEG) is increasing in critically-ill patients, but it is more resource-consuming than routine EEG (rEEG). Observational studies did not show a major impact of cEEG versus rEEG on outcome, but randomized studies are lacking.
Methods
We analyzed data of the CERTA trial (NCT03129438), including comatose adults after CA undergoing cEEG (30-48 hours) or two rEEG (20-30 minutes each). We explored correlations between recording EEG type and mortality (primary outcome), or Cerebral Performance Categories (CPC, secondary outcome), assessed blindly at 6 months, using uni- and multivariable analyses (adjusting for other prognostic variables showing some imbalance across groups).
Results
We analyzed 112 adults (52 underwent rEEG, 60 cEEG,); 31 (27.7%) were women; 68 (60.7%) patients died. In univariate analysis, mortality (rEEG 59%, cEEG 65%, p=0.318) and good outcome (CPC 1-2; rEEG 33%, cEEG 27%, p=0.247) were comparable across EEG groups. This did not change after multiple logistic regressions, adjusting for shockable rhythm, time to return of spontaneous circulation, serum neuron-specific enolase, EEG background reactivity, regarding mortality (rEEG vs cEEG: OR 1.60, 95% CI 0.43 - 5.83, p=0.477), and good outcome (OR 0.51, 95% CI 0.14 - 1.90, p=0.318).
Conclusion
This analysis suggests that cEEG or repeated rEEG are related to comparable outcomes of comatose patients after CA. Pending a prospective, large randomized trial, this finding does not support the routine use of cEEG for prognostication in this setting.
Keywords
Cardiology and Cardiovascular Medicine, Emergency Nursing, Emergency Medicine
Pubmed
Open Access
Yes
Funding(s)
Swiss National Science Foundation / 320030_169379
Create date
31/05/2022 10:31
Last modification date
25/06/2022 6:34
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