Combination of Clinical Exam, MRI and EEG to Predict Outcome Following Cardiac Arrest and Targeted Temperature Managemen
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ORIGINAL ARTICLE
Combination of Clinical Exam, MRI and EEG to Predict Outcome Following Cardiac Arrest and Targeted Temperature Management Matthew B. Bevers1*, Benjamin M. Scirica2, Kathleen Ryan Avery3, Galen V. Henderson1, Alexander P. Lin4 and Jong W. Lee5 © 2018 Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society
Abstract Background: Despite the widespread adoption of targeted temperature management (TTM), coma after cardiac arrest remains a common problem with a high proportion of patients suffering substantial disability. Prognostication after cardiac arrest, particularly the identification of patients with likely good outcome, remains difficult. Methods: We performed a retrospective study of 78 patients who underwent TTM after cardiac arrest and were evaluated with both electroencephalography (EEG) and magnetic resonance imaging (MRI). We hypothesized that combining malignant versus non-malignant EEG classification with clinical exam and quantitative analysis of apparent diffusion coefficient (ADC) and fluid-attenuated inversion recovery imaging would improve prognostic ability. Results: Consistent with prior literature, presence of a malignant EEG pattern was 100% specific for poor outcome. We found that decreased whole brain ADC signal intensity was associated with poor outcome (853 ± 14 vs. 950 ± 17.5 mm2/s, p
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