EEG for prognostication in postanoxic coma: what you predict depends on when you predict

Current protocols of targeted temperature management (TTM) for neuroprotection in resuscitated comatose patients require sedation and often paralysis in order to maintain consistent and low body temperatures during the frst 24-48 hours after return of spontaneous circulation as a result, predictors based on clinical examination are usually unreliable in the early postresuscitation phase,while predictors based on electrophysiology, namely short-latency somatosensory evoked potentials (SSEPs) and electroencephalogram (EEG) have been becoming increasingly popular after the advent of TTM. Recent studies show that the prdictive value of EEG changes according to the timing after arrest: while an early EEG (within 12-24h) is more suitable to predict good neurological outcome, an EEG recorded later (24-72h) is more accurate for predicting poor neurological outcome.