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The minimum and maximum were recorded during the periods without burst suppression and status epilepticus. We recorded the voltage values, continuous variables including maximum value, minimum value, average value, and the voltage span. Two leads are at bicentral regions (along the dashed line), and the other two leads are at biparietal regions. The reference lead is at the forehead region. (G) There are five leads in amplitude-electroencephalography. Representative figures of different patterns and standard lead placement of amplitude-electroencephalography. The first interpretable 2-h period of the aEEG was evaluated. The patients received targeted temperature therapy after ROSC, and aEEG was measured within 24 h after resuscitation. If the patients received coronary angiography, the final diagnosis and the culprit lesions were described according to the angiography results. If there was no ST-elevation, coronary angiography was guided by the patient’s symptoms, signs, and laboratory data in the CCU. If ST elevation was noticed on ECG, then coronary angiography would be performed immediately, and the patients would be treated as ST-elevation myocardial infarction. The timing of coronary angiography was judged based on clinical presentation and laboratory data. Blood was sampled for analysis during or just after ROSC, including biochemistry, blood gas, and electrolytes. Resuscitation information was collected from records of the Taipei Emergency Medical Technician Association and medical records. The baseline characteristics were collected from medical records. Therefore, we conducted this study to test this hypothesis. We hypothesized that the characteristics of aEEG in patients with a potentially good prognosis of neurologic function may be significantly different from those with a poor prognosis. 12 However, for those with cardiogenic etiologies, the predictive value is unclear. 13, 14 Continuous aEEG monitoring has been shown to provide substantial predictive value for neurologic outcomes in cardiac arrest patients who undergo hypothermic treatment during the post-resuscitation period. 12 In adults, an increasing number of studies have evaluated the role of aEEG. Subsequently, surveillance of cerebral activity by aEEG in infants has been gradually adopted, 10, 11 and it has been used in children for monitoring post-anoxic status for years. aEEG was first introduced in the 1960s, 9 and it has been used in neonates since the late 1980s. It is also difficult to arrange an EEG evaluation for these patients when they are treated in an intensive care unit.Īmplitude-integrated electroencephalography (aEEG) may be an alternative tool because it is easy to use and portable.
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8 However, reading continuous EEG is a complex task for general physicians. 7 Moreover, updated guidelines recommend EEG monitoring for neuroprognostic evaluation during the period of TTM. 5, 6 In addition, as increasing evidence has shown that the evolution of electroencephalogram (EEG) waveform may provide information on recovery from postanoxic coma, the American Heart Association guidelines suggest the application of EEG in comatose survivors after ROSC. It is also an essential factor in the withdrawal of life-sustaining therapy (WLST) during the post-resuscitation period.Īccording to the 2020 updated advanced cardiac life support guidelines, for patients experiencing cardiac arrest with a return of spontaneous circulation (ROSC), targeted temperature management (TTM) is recommended to conserve brain function, 3, 4 although TTM has side effects. 1, 2 Predicting the prognosis or neurological outcomes is vital when treating patients with potentially poor neurologic outcomes. 1, 2 Moreover, neurologic function can ultimately become severely impaired despite adequate medical management. Cardiac arrest is a significant public health issue, causing an estimated 15-20% of all deaths annually.