Abstracts

Rationale: Electroencephalographic (EEG) features may provide objective data regarding prognosis in children resuscitated from cardiac arrest (CA), but therapeutic hypothermia (TH) may impact its predictive value. We aimed to determine whether specific EEG features were predictive of short term outcome in children treated with TH after CA, both during hypothermia and after return to normothermia. Methods: Thirty-five children managed with a standard clinical TH algorithm after CA were prospectively enrolled. EEG recordings were scored in a standardized manner and categorized. EEG category 1 consisted of continuous and reactive tracings. EEG category 2 consisted of continuous but unreactive tracings. EEG category 3 included those with any degree of discontinuity, burst suppression, or lack of cerebral activity. The primary outcome was unfavorable short-term outcome defined as Pediatric Cerebral Performance Category score of 4-6 (severe disability, vegetative, death) at hospital discharge. Univariate analyses of the association between EEG category and outcome were performed using logistic regression. Results: For tracings obtained during hypothermia, patients with EEG scores of 2 or 3 were far more likely to have poor outcome than those with a score of 1 (OR 10.7, p=0.023; and OR 35, p=0.004, respectively). Similarly, for tracings obtained during normothermia, patients with EEG scores of 2 or 3 were far more likely to have poor outcomes than those with a score of 1 (OR 27, p= 0.006; and OR 18, p = 0.02, respectively). Conclusions: A simple EEG classification scheme has predictive value in children undergoing TH after CA.