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Int. J. Mol. Sci. 2015, 16(11), 25999-26018; https://doi.org/10.3390/ijms161125938

Electrophysiological Monitoring of Brain Injury and Recovery after Cardiac Arrest

1,2
,
3,4
and
1,2,5,6,*
1
Department of Biomedical Engineering, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
2
Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD 21201, USA
3
Department of Neurology, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
4
Neurological Institute, University Hospitals Case Medical Center, Cleveland, OH 44106, USA
5
Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
6
Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD 21201, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Irmgard Tegeder
Received: 9 September 2015 / Revised: 19 October 2015 / Accepted: 21 October 2015 / Published: 30 October 2015
(This article belongs to the Special Issue Neurological Injuries’ Monitoring, Tracking and Treatment)
Full-Text   |   PDF [5885 KB, uploaded 30 October 2015]   |  

Abstract

Reliable prognostic methods for cerebral functional outcome of post cardiac-arrest (CA) patients are necessary, especially since therapeutic hypothermia (TH) as a standard treatment. Traditional neurophysiological prognostic indicators, such as clinical examination and chemical biomarkers, may result in indecisive outcome predictions and do not directly reflect neuronal activity, though they have remained the mainstay of clinical prognosis. The most recent advances in electrophysiological methods—electroencephalography (EEG) pattern, evoked potential (EP) and cellular electrophysiological measurement—were developed to complement these deficiencies, and will be examined in this review article. EEG pattern (reactivity and continuity) provides real-time and accurate information for early-stage (particularly in the first 24 h) hypoxic-ischemic (HI) brain injury patients with high sensitivity. However, the signal is easily affected by external stimuli, thus the measurements of EP should be combined with EEG background to validate the predicted neurologic functional result. Cellular electrophysiology, such as multi-unit activity (MUA) and local field potentials (LFP), has strong potential for improving prognostication and therapy by offering additional neurophysiologic information to understand the underlying mechanisms of therapeutic methods. Electrophysiology provides reliable and precise prognostication on both global and cellular levels secondary to cerebral injury in cardiac arrest patients treated with TH. View Full-Text
Keywords: cardiac arrest; hypothermia; prognostication; electrophysiology; EEG; evoked potentials; ischemic brain injury cardiac arrest; hypothermia; prognostication; electrophysiology; EEG; evoked potentials; ischemic brain injury
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Deng, R.; Xiong, W.; Jia, X. Electrophysiological Monitoring of Brain Injury and Recovery after Cardiac Arrest. Int. J. Mol. Sci. 2015, 16, 25999-26018.

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