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

• Published in: Resuscitation Vol. 204; p. 110398
• Main Authors: Fahrner, Marlen G., Hwang, Jaeho, Cho, Sung-Min, Thakor, Nitish V., Habela, Christa W., Kaplan, Peter W., Geocadin, Romergryko G.
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01-11-2024
• Subjects: Cardiac arrest; Coma; EEG; Neuroprognostication; Reactivity; Review; Coma; Reactivity; Review; EEG; Neuroprognostication; Cardiac arrest; neuroprognostication; reactivity; cardiac arrest; review; coma
• ISSN: 0300-9572; 1873-1570; 1873-1570
• DOI: 10.1016/j.resuscitation.2024.110398

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.