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Bedside interpretation of simplified continuous EEG after cardiac arrest

Acta Anaesthesiologica Scandinavica Oct 09, 2019

Lybeck A, Cronberg T, Borgquist O, et al. - Researchers sought to evaluate ICU physicians' ability to conduct preliminary interpretations of a simplified continuous EEG-monitoring (cEEG) in the postcardiac arrest setting. Training in the interpretation of simplified cEEG was provided to five ICU physicians - total training duration 1 day. Then, 71 simplified cEEG recordings from 37 comatose survivors of cardiac arrest were given to the ICU physicians for interpretation. ICU physicians and the EEG-expert showed substantial agreement (κ 0.69) for EEG background patterns and moderate agreement (κ 0.43) for epileptiform discharges. The findings thereby suggest that preliminary bedside interpretations of simplified cEEGs by trained ICU physicians may enable earlier detection of clinically important cEEG changes following cardiac arrest, which may assist in making prompt changes in patient management as well as additional evaluation by an EEG-expert. In this strategy, there appeared a requirement for awareness of limitations of both the simplified electrode montage and the cEEG interpretations conducted by ICU physicians. No delay to cEEG evaluation by an expert is supported.
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