Abstracts

Rationale: Cardiac arrest results in systemic hypoperfusion leading to subsequent temperature sensitive cell destruction, multiorgan failure, and neuronal apoptosis. Hypothermia has been shown to lessen these harmful effects, thus, providing a degree of protection to the brain and heart. However, hypothermia also has systemic risk of immunosuppression, electrolyte imbalance and increased bleeding. It is the standard of care for post cardiac arrest patients to receive actively induced cooling to a target temperature of 32°C to 36°C. Recent literature suggests cooling to 36°C can limit the systemic side effects. We aimed to compare the EEG prognostic value in post cardiac arrest patient with a target temperature of 33°C and 36°C. Methods: We conducted a retrospective chart review of patients who experienced cardiac arrest and underwent hypothermic cooling protocol, with cooling to either 33°C or 36°C. The patients were admitted to Dartmouth Hitchcock Medical Center between December, 2017 and May, 2019. Descriptive statistics were compared amongst the two groups using a Chi test. Results: Of the 48 patients reviewed, 30 patients were cooled to 36°C (Group A) and 18 were cooled to 33°C (Group B). Of those cooled to 36°C, 9 had no ominous findings, of which 6 survived, while 9 patients had ominous findings on EEG, of which 3 survived. Of those cooled to 33°C, 19 had no ominous findings, of which 16 survived, while 11 patients had ominous findings on EEG, of which 7 survived.  Conclusions: The prognostic value of EEG was improved in those patients who underwent cooling protocol at 36°C (p=0.16) versus those who were cooled to 33°C (p=0.2). However, it is important to note that neither group found a statistically significant difference in mortality between patients with normal EEG and those with EEG with ominous findings. This finding was likely a result of the small sample size. There is value in continuing this study to increase the sample size in order to determine if cooling temperature affects the prognostic value of EEG. Funding: No funding