Abstracts

Hypothermia is being used to reduce the adverse effects of hypoperfusion and to improve outcomes following cardiac arrest. We examined the relationship between electrographic seizures and clinical outcome., We collected data on 28 consecutive comatose adult patients who were resuscitated after cardiac arrest, and treated according to an institutional hypothermia protocol. EEG was recorded prior to hypothermia induction and continued for at least 24 hours, or was repeated at 24 hours. Patients received intravenous propofol or midazolam, and neuromuscular blockade. They were cooled to 33^o C. over 3 to 8 hours, maintained at that temperature for 24 hours, and then passively warmed, by 1^oC. in four hours, to 36.5^o C. Outcomes at discharge were recorded., Ages ranged from 34 - 84 years, with 61% males and 39% females. Eight patients (29%) demonstrated either myoclonic status epilepticus (SE), electrographic seizures, or nonconvulsive SE, and mortality in this group of patients was 87.5%. Only one of these patients survived, with neurological deficits. Of patients without seizure activity, 50% survived with good neurological and functional outcome, and 50% died., In this population of patients who suffered cardiac arrest, seizure activity was associated with a higher mortality. These observations emphasize the importance of EEG monitoring in this setting, and may help to predict outcomes in post-cardiac arrest patients who are treated with hypothermia., (Supported by NIH P50 NS25630.)