Format

Send to

Choose Destination
See comment in PubMed Commons below
Pediatr Crit Care Med. 2007 Jan;8(1):10-7.

Retrospective analysis of the prognostic value of electroencephalography patterns obtained in pediatric in-hospital cardiac arrest survivors during three years.

Author information

1
Department of Anesthesiology and Critical Care Medicine, the Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Abstract

OBJECTIVE:

To test the hypothesis that electroencephalography has prognostic value in children after in-hospital cardiac arrest.

DESIGN:

Single-center, retrospective chart review.

SETTING:

Urban tertiary care children's hospital, January 2001 to July 2004.

PATIENTS:

Thirty-four consecutive children were identified from a registry of all patients resuscitated for cardiac arrest. Inclusion criteria were age >44 wks postmenstrual age to 18 yrs, survival after in-hospital cardiac arrest >24 hrs, and undergoing electroencephalography within 7 days after the cardiac arrest.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

Prearrest, event, cardiopulmonary resuscitation, and postresuscitation variables were collected. Neurologic outcome was assessed by Pediatric Cerebral Performance Category (PCPC). Prearrest PCPC was estimated from chart review. Change in PCPC >1 or death between prearrest and time of hospital discharge was defined as poor neurologic outcome. Experts blinded to PCPC outcomes scored electroencephalographs from 1 (normal) to 5 (isoelectric). Sensitivity/specificity analysis and receiver operating characteristic curve were developed with each electroencephalography grade cutoff. Of 184 consecutive patients who had cardiac arrests in our registry, 107 survived >24 hrs, and 83 met study criteria. Thirty-four patients had electroencephalography within the first 7 days after the cardiac arrest. Among those, 16 (47%) patients had good neurologic outcome defined as no change in PCPC, and 18 (53%) died or had poor neurologic outcome. Univariate analysis showed that a higher electroencephalography score performed within 7 days was associated with poor neurologic outcome (p < .05). Positive predictive value of electroencephalography grade 4-5 for poor neurologic outcome was 90%, and negative predictive value of electroencephalography grade 1-2 for poor neurologic outcome was 91%.

CONCLUSIONS:

In a single-center consecutive case series, electroencephalography background patterns during the initial 7 days after in-hospital cardiac arrest were associated with neurologic outcome in children.

[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments

    Supplemental Content

    Full text links

    Icon for Wolters Kluwer
    Loading ...
    Support Center