Acute cardiac care & resuscitationCohort study
Relationship between cortical electrical responsiveness and changes in regional cerebral oxygenation (rSO2) and return of spontaneous circulation in prolonged cardiac arrest: a multi-center observational study
- ancillary cohort analysis of a multicenter, prospective observational study
Authors' conclusion
Near-physiologic brain activity may be restored during prolonged CPR if oxygenation thresholds are met and is associated with ROSC. Further research is needed to evaluate survival outcomes.
Study context
- Population
- Consecutive adult patients with in-hospital cardiac arrest monitored with EEG and near-infrared spectroscopy (rSO2) during cardiopulmonary resuscitation (CPR)cardiac arrests, 53 yielded interpretable EEG recordings
- Participants
- 85 patients
Main finding
As reported in the abstract
Cardiac arrest duration
median duration
31 min, IQR 23-45
Observational data: associations, not effects.
Further findings
Return of spontaneous circulation (ROSC) by EEG pattern
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| Alpha activity · associated with ROSC | 5.4 (1.08–29.20) | P = 0.045 | |
| Suppression · lower ROSC odds | 0.12 (0.02–0.53) | P = 0.002 | |
| 0.050.21520Odds ratio (log scale) |
EEG patterns during CPR
- Diffuse cortical suppression
- 47%
- near-normal rhythms
- 40%
- delta
- 22%
- theta
- 12%
- alpha
- 6%
- pathologic activity
- 13%
rSO2 thresholds for EEG activity
- Delta and theta emerged at rSO2
- ≥16%
- alpha at rSO2
- >40%
Timing of activity into CPR
min
- Alpha activity seen up to
- 35
- delta/theta seen up to
- 60
Suppression reverting to near-normal
- of transitions
- 12%
Survival analysis
- Survival analysis was limited by small sample size
Original publication
Relationship between cortical electrical responsiveness and changes in regional cerebral oxygenation (rSO2) and return of spontaneous circulation in prolonged cardiac arrest: a multi-center observational study. Resuscitation. Published 25 February 2026. doi:10.1016/j.resuscitation.2026.111031
Summarised from the published abstract; every number is checked against it