Abstracts

Rationale: . Induced hypothermia as a treatment for patients after cardiac arrest has been proven to provide a protective effect in the histopathological changes of ischemia (1) and has become the standard of care for these patients. Abnormal EEG patterns correlate with a poorer prognosis (4) EEG may present characteristics and background features predictive of seizures in children undergoing therapeutic hypothermia (6). We aimed to describe the EEG characteristics of pediatric patients that underwent IH after cardiac arrest and correlate EEG findings and outcome Methods: Three children ages 0-6 months underwent therapeutic hypothermia after cardiac arrest in the Pediatric Intensive Care at Stony Brook University Hospital between June 2013 and May 2014. EEG monitoring was performed during hypothermia, rewarming and normothermia. EEG characteristics and outcome were described . Results: Only 33.3 % of the patients (1/3) had Generalized Periodic Epilectiform Discharges, (GPDs) and there was no electrographic seizures in any of the patients .Poor outcome was seen in 66.6 % of the patients (2/3); they became neurological devastated upon discharge. 100 % of the patients during hypothermia had delta activity (1-3HZ) and 66.6 % showed moderate to rare theta activity. During the rewarming process, there was no change in background in 100 % of the patients. During hypothermia and rewarming 100 % of the patients did not show discernible posterior dominant rhythm and 50% (1/2) of the patients with poor outcome did not show sleep architecture the other 50 %( 1/2) showed poorly formatted sleep spindles and vertex waves. EEG after normothermia in patients with poor outcome (2/3) shows persistent Delta activity and no evolution of the background. Conclusions: EEG characteristic during TI is a useful tool to determinate seizure potential and guide therapy in order to prevent epileptic activity and assess prognosis.The lack of evolution in the background from hypothermia/rewarming to normothermia may be an indicator of poor outcome.