Antiseizure Treatment Explored in Comatose Cardiac Arrest Survivors

Strategy to suppress rhythmic and periodic EEG patterns did not improve neurologic outcomes at three months

HealthDay News — For comatose survivors of cardiac arrest, the incidence of poor neurologic outcome at 3 months does not differ when a strategy to suppress rhythmic and periodic electroencephalographic (EEG) patterns is added to standard care, according to a study published in the February 24 issue of the New England Journal of Medicine.

Barry J. Ruijter, MD, PhD, from the University of Twente in Enschede, Netherlands, and colleagues conducted an open-label trial of suppressing rhythmic and periodic EEG patterns detected on continuous EEG monitoring in cardiac arrest survivors who were comatose. Patients were randomly assigned to a stepwise strategy of antiseizure medications to suppress this activity for at least 48 hours plus standard care or to standard care alone (88 and 84 patients, respectively).

The researchers found that complete suppression of rhythmic and periodic EEG activity for 48 hours occurred in 56 and 2% of patients in the antiseizure-treatment and control groups, respectively. At 3 months, a poor neurologic outcome occurred in 90 and 92% of patients in the antiseizure treatment and control groups, respectively (difference, 2 percentage points; 95% CI, −7 to 11; P =.68). At 3 months, mortality was 80 and 82% in the antiseizure treatment and control groups, respectively. Compared with the control group, the antiseizure-treatment group had a slightly longer mean length of stay in the intensive care unit and mean duration of mechanical ventilation.

“Suppressing these EEG patterns during targeted temperature management after cardiac arrest offers no benefit in a population destined to do poorly,” writes the author of an accompanying editorial.

Abstract/Full Text (subscription or payment may be required)

Editorial (subscription or payment may be required)