Abstract
Monitoring cerebral circulation during cardiopulmonary resuscitation (CPR) is essential to improve patients’ prognosis and quality of life. We assessed the feasibility of non-invasive electroencephalography (EEG) parameters as predictive factors of cerebral resuscitation in a ventricular fibrillation (VF) swine model. After 1 min untreated VF, four cycles of basic life support were performed and the first defibrillation was administered. Sustained return of spontaneous circulation (ROSC) was confirmed if a palpable pulse persisted for 20 min. Otherwise, one cycle of advanced cardiovascular life support (ACLS) and defibrillation were administered immediately. Successfully defibrillated animals were continuously monitored. If sustained ROSC was not achieved, another cycle of ACLS was administered. Non-ROSC was confirmed when sustained ROSC did not occur after 10 ACLS cycles. EEG and hemodynamic parameters were measured during experiments. Data measured for approximately 3 s right before the defibrillation attempts were analyzed to investigate the relationship between the recovery of carotid blood flow (CBF) and non-invasive EEG parameters, including time- and frequency-domain parameters and entropy indices. We found that time-domain magnitude and entropy measures of EEG correlated with the change of CBF. Further studies are warranted to evaluate these EEG parameters as potential markers of cerebral circulation during CPR.
Highlights
395,000 adults experience an out-of-hospital cardiac arrest (OHCA) annually in the US, and their overall survival rate is only 6–11% [1,2,3]
The application of EEG monitoring has expanded to the cardiopulmonary resuscitation (CPR) situation, and distinctive EEG patterns are suggested as possible markers for the quality of cerebral resuscitation and oxygen delivery [19]
We focused on the investigation of the relationship between the recovery of carotid blood flow and non-invasive EEG parameters, including time- and frequency-domain parameters, and entropy indices between defibrillation attempts
Summary
395,000 adults experience an out-of-hospital cardiac arrest (OHCA) annually in the US, and their overall survival rate is only 6–11% [1,2,3]. Once cerebral oxygenation decreases due to cardiac arrest (CA), the EEG activity gradually enters the isoelectric state [12,13,14]. The application of EEG monitoring has expanded to the CPR situation, and distinctive EEG patterns are suggested as possible markers for the quality of cerebral resuscitation and oxygen delivery [19]. The direct relationship between the carotid blood flow (CBF) recovery and the EEG during CPR has been rarely discussed. We focused on the investigation of the relationship between the recovery of carotid blood flow and non-invasive EEG parameters, including time- and frequency-domain parameters, and entropy indices between defibrillation attempts. We hypothesized that CBF recovery may improve cerebral electrical activity, which can result in EEG changes, even during short intervals between defibrillation attempts
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