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Neurobehavioural outcomes in children after In-Hospital cardiac arrest. | LitMetric

AI Article Synopsis

  • The study investigates neurobehavioural outcomes in children who survived in-hospital cardiac arrest (IH-CA) and were initially comatose, comparing two temperature management interventions during resuscitation.
  • A significant number of participants with previously normal neurobehavioural functioning showed declines in their abilities over 3 and 12 months post-IH-CA, although most maintained scores within a generally normal range.
  • The findings highlight that despite some improvements, many pediatric survivors of IH-CA face challenges in cognitive and adaptive functioning, emphasizing the need for ongoing assessment and support.

Article Abstract

Aim: Children who remain comatose after in-hospital cardiac arrest (IH-CA) resuscitation are at risk for poor neurological outcome. We report results of detailed neurobehavioural testing in paediatric IH-CA survivors, initially comatose after return of circulation, and enrolled in THAPCA-IH, a clinical trial that evaluated two targeted temperature management interventions (hypothermia, 33.0 °C or normothermia, 36.8 °C; NCT00880087).

Methods: Children, aged 2 days to <18 years, were enrolled in THAPCA-IH from 2009 to 2015; primary trial outcome (survival with favorable neurobehavioural outcome) did not differ between groups. Pre-IH-CA neurobehavioural functioning, measured with the Vineland Adaptive Behavior Scales, Second Edition (VABS-II) was evaluated soon after enrollment; this report includes only children with broadly normal pre-IH-CA scores (VABS-II composite scores ≥70; 269 enrolled). VABS-II was re-administered 3 and 12 months later. Cognitive testing was completed at 12 months.

Results: Follow-ups were obtained on 125 of 135 eligible one-year survivors. Seventy-seven percent (96/125) had VABS-II scores ≥70 at 12 months; cognitive composites were ≥2SD of mean in 59%. VABS-II composite, domain, and most subdomain scores declined between pre-IH-CA and 3-month, and pre-IH-CA and 12-month assessments (composite means declined about 1 SD at 3 and 12 months, p < 0.005); 3 and 12-month scores were strongly correlated (r = 0.72, p < 0.001).

Conclusions: In paediatric IH-CA survivors at high risk for unfavorable outcomes, the majority demonstrated significant declines in neurobehavioural functioning, across multiple functional domains, with similar functioning at 3 and 12 months. About three-quarters attained VABS-II functional performance composite scores within the broadly normal range.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5837951PMC
http://dx.doi.org/10.1016/j.resuscitation.2018.01.002DOI Listing

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