{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T17:32:34Z","timestamp":1778002354339,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010600","name":"Tays","doi-asserted-by":"publisher","award":["T63694"],"award-info":[{"award-number":["T63694"]}],"id":[{"id":"10.13039\/501100010600","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010135","name":"Finska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010135","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Early restitution of electroencephalogram (EEG) slow wave activity (SWA) may be able to predict favorable functional outcome after cardiac arrest. SWA can be monitored using the C\u2010Trend Index, a recently developed dynamic numerical index computed using commercially available medical device software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a pre\u2010planned prospective substudy of the randomized controlled Sedation, TEmperature and Pressure after Cardiac Arrest and REsuscitation (STEPCARE) trial. With a factorial design, the STEPCARE trial evaluates the effects of three different interventions (sedation, temperature management, and mean arterial blood pressure) on functional outcomes in adult out\u2010of\u2010hospital cardiac arrest (OHCA) patients. We will record continuous EEG (cEEG) starting as early as possible after ICU admission. We will compare the accuracy (the proportion of correct predictions of all predictions) of C\u2010Trend Index with that of blinded retrospective visual analysis of cEEG at 12\u2009h after return of spontaneous circulation in predicting favorable functional outcome (modified Rankin Scale 0\u20133) 6\u2009months after cardiac arrest. We aim to recruit 300 patients to show noninferiority in prognostic accuracy of the C\u2010Trend Index compared with the visual analysis of cEEG, using a 2% limit for noninferiority. Furthermore, we will assess whether the therapeutic intervention related to sedation, carried out as a part of the STEPCARE trial modifies the performance of the EEG\u2010based predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The study will compare the accuracy of SWA measured using C\u2010Trend Index with the gold standard, visual analysis of cEEG, in predicting favorable functional outcome after OHCA. The study will also assess the effect of the sedation intervention of the STEPCARE trial on the predictive accuracy of C\u2010Trend Index. If the accuracy of the C\u2010Trend Index is non\u2010inferior to the comparator's, it may provide a feasible and easy\u2010to\u2010learn bedside method, especially in hospitals with limited availability of neurophysiology expertise.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov identifier: NCT06564675<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.70126","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T07:57:07Z","timestamp":1758095827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Accuracy of <scp>EEG<\/scp> Slow Wave Activity in Predicting Favorable Outcome in Patients With Hypoxic Brain Injury\u2014A Protocol for a Substudy of the <scp>STEPCARE<\/scp> Trial"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3613-7231","authenticated-orcid":false,"given":"Johanna","family":"H\u00e4stbacka","sequence":"first","affiliation":[{"name":"Department of Intensive Care, Faculty of Medicine and Health Technology Tampere University Hospital, Wellbeing Services County of Pirkanmaa and Tampere University  Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Westhall","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Lund University  Lund Sweden"},{"name":"Department of Clinical Neurophysiology Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Moseby\u2010Knappe","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Lund University  Lund Sweden"},{"name":"Department of Neurology and Rehabilitation Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marjaana","family":"Tiainen","sequence":"additional","affiliation":[{"name":"Department of Neurology Helsinki University Hospital and University of Helsinki  Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7574-3958","authenticated-orcid":false,"given":"Anna","family":"Lybeck","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund Lund University  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6878-3740","authenticated-orcid":false,"given":"Matti","family":"Reinikainen","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Kuopio University Hospital, University of Eastern Finland  Kuopio 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