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Chapter 15 - Neuromonitoring after Cardiac Arrest

from Part IV - Practice of Neuromonitoring: Cardiac Intensive Care Unit

Published online by Cambridge University Press:  08 September 2022

By
Genevieve Du Pont-Thibodeau ,
Nicholas S. Abend  and
Alexis A. Topjian
Edited by
Cecil D. Hahn  and
Courtney J. Wusthoff
Cecil D. Hahn
Affiliation:
The Hospital for Sick Children, University of Toronto
Courtney J. Wusthoff
Affiliation:
Lucile Packard Children’s Hospital, Stanford University
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Summary

The period following resuscitation after cardiac arrest is a critical time during which the identification and management of neurological injury may lead to increased survival and improved long-term functional outcomes. Neuromonitoring can guide patient management and aid in prognostication following cardiac arrest. EEG background patterns may be useful in outcome prognostication for some patients within 24 hours of cardiac arrest. Similarly, EEG monitoring is often employed for detection of seizures after pediatric cardiac arrest; seizures are common and are most often subclinical. Hypothermia may impact the interpretation and optimal timing of neuromonitoring data used for prognostication. Experts recommend a multimodal approach to prognostication. In this chapter, we discuss cEEG monitoring, quantitative EEG methods for seizure identification, and EEG background interpretation. We discuss SSEPs and NIRS and their respective roles in neurological management and prognostication. We also address how therapeutic hypothermia (TH) and medication exposure can change the reliability of some of these neuromonitoring tools.

Keywords

cEEGQEEGseizureprognosticationcardiac arrestsomatosensory evoked potentials (SSEPs)near-infrared spectroscopy (NIRS)hypothermia
Type
Chapter
Information
Neuromonitoring in Neonatal and Pediatric Critical Care , pp. 189 - 204
Publisher: Cambridge University Press
Print publication year: 2022

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