Monitoring of a middle latency auditory evoked potential index during postresuscitation care with induced therapeutic hypothermia

A 48-year-old man suddenly suffered a cardiac arrest at the supermarket and underwent bystander cardiopulmonary resus-citation. During transportation to our emergency center, ventricular fibrillation occurred and defibrillation was successful. Restoration of spontaneous circulation (ROSC) with sinus rhythm occurred 12 min after sudden cardiac arrest. On arrival at the emergency center 2 min after ROSC, middle latency auditory evoked potential index (MLAEPi) was measured and MLA-EPi monitoring was continued to post-resuscitation care with induced therapeutic hypothermia (TH). This case highlights the usefulness of MLAEPi monitoring during primary care in the emergency center and postresuscitation care, including TH, for predicting neurological outcome.

resuscitation, cardiopul-monary arrest, monitoring, prognosis

1. Shibata S, Imota T, Shigeomi S, Sato W, Enzan K. Use of the bispectral index during the early postresuscitative phase after out-of-hospital cardiac arrest. J Anesth 2005;19:243-6.

2. Fatovich DM, Jacobs IG, Celenza A, Peach MJ. An observational study of bispectral index monitoring for out of hospital cardiac arrest. Resuscitation 2006;69:207-12.

3. Chollet-Xémard C, Combes X, Soupizet F, Jabre P, Penet C, Bertrand C, et al. Bispectral index monitoring is useless during cardiac arrest patient’s resuscitation. Resuscitation 2009;80:213-6.

4. Kaul HL, Bhati N. Monitoring depth of anaesthesia. Indian J Anaesth 2002;46:323-32.

5. Bemard SA, Gray TW, Buist MD, Jones BM, Silvester W, Gutteridge G, et al. Treatment of comatose syrvivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med 2002;346:557-63.

6. The hypothermia after cardiac arrest study group. Mid therapeutic hypothermia to improve the neurologic outcome after cardiac arrest. N Engl J Med 2002;346:549-56.

7. Doi M, Morita K, Mantzaridis H, Sato S, Kenny GN. Prediction of responses to various stimuli during sedation: a comparison of three EEG variables. Intensive Care Med 2005;31:41-7.

8. Doi M, Gajraj RJ, Mantzaridis H, Kenny GNC. Relationship between calculated blood concentration of propofol and electrophysiological variables during emergence from anaesthesia: comparison of bispectral index, spectral edge frequency, median frequency and auditory evoked potential index. Br J Anaesth 1997;78:180–4.