Clinical approach to burst-suppression pattern in intensive care unit: basic and updates

Abstract

A burst-suppression pattern is an electroencephalographic pattern characterized by a quasi-periodic high amplitude “burst” alternating with periods of low or flatline “suppression.” Recognizing and understanding this pattern is helpful for clinical management in intensive care units. Pathological burst-suppression is commonly seen in post cardiac arrest comatose patients. It can also be induced by anesthetics or hypothermia. A burst-suppression pattern in anoxic brain injury generally predicts a poor prognosis; however, exceptions do occur. Inducing burst-suppression by general anesthetics can be used to abort super-refractory status epilepticus. This article will discuss this unique EEG pattern, including basic mechanisms, related clinical conditions, and recent research updates.