EEG Reactivity Evaluation Practices for Adult and Pediatric Hypoxic-Ischemic Coma Prognostication in North America.
Publication/Presentation Date
11-1-2018
Abstract
PURPOSE: The aim of this study was to assess the variability in EEG reactivity evaluation practices during cardiac arrest prognostication.
METHODS: A survey of institutional representatives from North American academic hospitals participating in the Critical Care EEG Monitoring Research Consortium was conducted to assess practice patterns involving EEG reactivity evaluation. This 10-question multiple-choice survey evaluated metrics related to technical, interpretation, personnel, and procedural aspects of bedside EEG reactivity testing and interpretation specific to cardiac arrest prognostication. One response per hospital was obtained.
RESULTS: Responses were received from 25 hospitals, including 7 pediatric hospitals. A standardized EEG reactivity protocol was available in 44% of centers. Sixty percent of respondents believed that reactivity interpretation was subjective. Reactivity bedside testing always (100%) started during hypothermia and was performed daily during monitoring in the majority (71%) of hospitals. Stimulation was performed primarily by neurodiagnostic technologists (76%). The mean number of activation procedures modalities tested was 4.5 (SD 2.1). The most commonly used activation procedures were auditory (83.3%), nail bed pressure (63%), and light tactile stimuli (63%). Changes in EEG amplitude alone were not considered consistent with EEG reactivity in 21% of centers.
CONCLUSIONS: There is substantial variability in EEG reactivity evaluation practices during cardiac arrest prognostication among North American academic hospitals. Efforts are needed to standardize protocols and nomenclature according with national guidelines and promote best practices in EEG reactivity evaluation.
Volume
35
Issue
6
First Page
510
Last Page
514
ISSN
1537-1603
Published In/Presented At
Amorim, E., Gilmore, E. J., Abend, N. S., Hahn, C. D., Gaspard, N., Herman, S. T., Hirsch, L. J., Lee, J. W., Cash, S. S., & Westover, M. B. (2018). EEG Reactivity Evaluation Practices for Adult and Pediatric Hypoxic-Ischemic Coma Prognostication in North America. Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society, 35(6), 510–514. https://doi.org/10.1097/WNP.0000000000000517
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
30216207
Department(s)
Department of Pediatrics
Document Type
Article