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Review
. 2024 Nov:204:110398.
doi: 10.1016/j.resuscitation.2024.110398. Epub 2024 Sep 12.

EEG reactivity in neurologic prognostication in post-cardiac arrest patients: A narrative review

Marlen G Fahrner  1 , Jaeho Hwang  2 , Sung-Min Cho  3 , Nitish V Thakor  4 , Christa W Habela  2 , Peter W Kaplan  2 , Romergryko G Geocadin  5
Affiliations
Review

EEG reactivity in neurologic prognostication in post-cardiac arrest patients: A narrative review

Marlen G Fahrner et al. Resuscitation. 2024 Nov.

Abstract

Electroencephalographic reactivity (EEG-R) is a promising early predictor of arousal in comatose patients after cardiac arrest. Despite recent guidelines advocating for the integration of EEG-R into the multimodal prognostication model, EEG-R testing methods remain heterogeneous across studies. While efforts towards standardization have been made to reduce interrater variability by the development of quantitative approaches and machine learning models, future validation studies are needed to increase clinical applicability. Furthermore, the specific neurophysiological mechanisms and neuroanatomical correlates underlying EEG-R are not fully understood. In this narrative review, we explore the value and possible mechanisms of EEG-R, focusing on post-cardiac arrest comatose patients. We aim to discuss the current standard of knowledge and future directions, as well as elucidate possible implications for patient care and research.

Keywords: Cardiac arrest; Coma; EEG; Neuroprognostication; Reactivity; Review.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Geocadin and Dr. Thakor are supported in part by cardiac arrest related grants from the National Institutes of Health (NIH) (UH3HL145269-04; RO1HL071568; RO1NS119825; RO1 NS 127959). Dr. Cho is funded by the NIH (K23HL157610). Dr. Habela is supported by the Doris Duke Foundation and the NIH Clinical Scientist Award (K08NS102526). Dr. Kaplan has been an expert witness on qEEG, a member of the ExCo of IFCN and receives royalties from publication from Wiley-Blackwell and Demos. Dr. Geocadin is a member of the Editorial Board of Resuscitation.

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