TY - JOUR
T1 - Paediatric in-hospital cardiac arrest
T2 - Factors associated with survival and neurobehavioural outcome one year later
AU - Meert, Kathleen
AU - Telford, Russell
AU - Holubkov, Richard
AU - Slomine, Beth S.
AU - Christensen, James R.
AU - Berger, John
AU - Ofori-Amanfo, George
AU - Newth, Christopher J.L.
AU - Dean, J. Michael
AU - Moler, Frank W.
N1 - Funding Information:
“Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1 RR 024986 and UL1 TR 000433. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.”
Funding Information:
Primary support for the conduct of the THAPCA-IH Trial was funding from the National Institutes of Health (NIH) , National Heart, Lung, and Blood Institute, Bethesda, MD . HL094345 (FWM) and HL094339 (JMD). Additional support from the following federal planning grants contributed to the planning of the THAPCA Trials: NIH, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), Bethesda, MD. HD044955 (FWM) and HD050531 (FWM). In part support was obtained from the participation of the following research networks: Paediatric Emergency Care Applied Research Network (PECARN) from cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, and U03MC00008; and the Collaborative Paediatric Critical Care Research Network (CPCCRN) from cooperative agreements (U10HD500009, U10HD050096, U10HD049981, U10HD049945, U10HD049983, U10HD050012 and U01HD049934. At several centres (as indicated below), clinical research support was supplemented by the following grants or Cooperative Agreements : UL1 RR 024986, UL1 TR 000433, U54 HD087011, UL1TR000003, and P30HD040677. The National Emergency Medical Services for Children (EMSC) Data Analysis Resource Centre Demonstration grant U07MC09174 provided for educational study materials. This work is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or National Institutes of Health.
Funding Information:
Our follow ups were conducted in the Clinical Research Center which is supported by NIH P30HD040677
Funding Information:
The project described was supported by the National Centre for Research Resources and the National Centre for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR000003. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
Funding Information:
Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number U54 HD087011 to the Intellectual and Developmental Disabilities Research Centre at Washington University. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health
Publisher Copyright:
© 2018 Elsevier B.V.
PY - 2018/3
Y1 - 2018/3
N2 - Objective To investigate clinical characteristics associated with 12-month survival and neurobehavioural function among children recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital trial. Methods Children (n = 329) with in-hospital cardiac arrest who received chest compressions for ≥2 min, were comatose, and required mechanical ventilation after return of circulation were included. Neurobehavioural function was assessed using the Vineland Adaptive Behaviour Scales, second edition (VABS-II) at baseline (reflecting pre-arrest status) and 12 months post-arrest. Norms for VABS-II are 100 (mean) ±15 (SD). Higher scores indicate better functioning. Outcomes included 12-month survival, 12-month survival with VABS-II decreased by ≤15 points from baseline, and 12-month survival with VABS-II ≥70. Results Asystole as the initial arrest rhythm, administration of >4 adrenaline doses, and higher post-arrest blood lactate concentration were independently associated with lower 12-month survival; an adrenaline dosing interval of 3–<5 min and open chest compressions were independently associated with greater 12-month survival. Use of extracorporeal membrane oxygenation (ECMO) and higher blood lactate were independently associated with lower 12-month survival with VABS-II decreased by ≤15 points from baseline; open chest compressions was independently associated with greater 12-month survival with VABS-II decreased by ≤15 points. Asystole as the initial rhythm, use of ECMO, and higher blood lactate were independently associated with lower 12-month survival with VABS-II ≥70; open chest compressions was independently associated with greater 12-month survival with VABS-II ≥70. Conclusions Cardiac arrest and resuscitation factors are associated with long-term survival and neurobehavioural function among children who are comatose after in-hospital arrest.
AB - Objective To investigate clinical characteristics associated with 12-month survival and neurobehavioural function among children recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital trial. Methods Children (n = 329) with in-hospital cardiac arrest who received chest compressions for ≥2 min, were comatose, and required mechanical ventilation after return of circulation were included. Neurobehavioural function was assessed using the Vineland Adaptive Behaviour Scales, second edition (VABS-II) at baseline (reflecting pre-arrest status) and 12 months post-arrest. Norms for VABS-II are 100 (mean) ±15 (SD). Higher scores indicate better functioning. Outcomes included 12-month survival, 12-month survival with VABS-II decreased by ≤15 points from baseline, and 12-month survival with VABS-II ≥70. Results Asystole as the initial arrest rhythm, administration of >4 adrenaline doses, and higher post-arrest blood lactate concentration were independently associated with lower 12-month survival; an adrenaline dosing interval of 3–<5 min and open chest compressions were independently associated with greater 12-month survival. Use of extracorporeal membrane oxygenation (ECMO) and higher blood lactate were independently associated with lower 12-month survival with VABS-II decreased by ≤15 points from baseline; open chest compressions was independently associated with greater 12-month survival with VABS-II decreased by ≤15 points. Asystole as the initial rhythm, use of ECMO, and higher blood lactate were independently associated with lower 12-month survival with VABS-II ≥70; open chest compressions was independently associated with greater 12-month survival with VABS-II ≥70. Conclusions Cardiac arrest and resuscitation factors are associated with long-term survival and neurobehavioural function among children who are comatose after in-hospital arrest.
KW - In-hospital cardiac arrest
KW - Neurobehavioural outcome
KW - Paediatric
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U2 - 10.1016/j.resuscitation.2018.01.013
DO - 10.1016/j.resuscitation.2018.01.013
M3 - Article
C2 - 29317348
AN - SCOPUS:85040327556
SN - 0300-9572
VL - 124
SP - 96
EP - 105
JO - Resuscitation
JF - Resuscitation
ER -