TY - JOUR
T1 - Neurobehavioral outcomes in children after out-of-hospital cardiac arrest
AU - Slomine, Beth S.
AU - Silverstein, Faye S.
AU - Christensen, James R.
AU - Holubkov, Richard
AU - Page, Kent
AU - Michael Dean, J.
AU - Moler, Frank W.
N1 - Funding Information:
funding from National Institutes of Health U01HL094345 (Dr Moler) and U01HL094339 (Dr Dean). Additional support from the following federal grants contributed to the planning of the Therapeutic Hypothermia after Pediatric Cardiac Arrest Trials: Eunice Kennedy Shriver National Institute of Child Health and Development, Bethesda, MD, HD044955 (Dr Moler) and HD050531 (Dr Moler). In part, support was from the participation of the following research networks: Pediatric Emergency Care Applied Research Network from cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, and U03MC00008; and the Collaborative Pediatric Critical Care Research Network from cooperative agreements U10HD500009, U10HD050096, U10HD049981, U10HD049945, U10HD049983, U10HD050012, and U01HD049934. At several centers, clinical research support was supplemented by the following grants or cooperative agreements: UL1TR000003, P30HD040677, P30HD062171, U07MC09174, UL1 RR 024986, and UL1 TR 000433. Funded by the National Institutes of Health (NIH).
Publisher Copyright:
© 2016 by the American Academy of Pediatrics.
PY - 2016/4
Y1 - 2016/4
N2 - Objective: This study examined 12-month neurobehavioral outcomes in children who survived out-of-hospital cardiac arrest (OH-CA), were comatose after resuscitation, and were enrolled in a clinical trial to evaluate targeted temperature management to hypothermia (33.0°C) or normothermia (36.8°C) (Therapeutic Hypothermia after Pediatric Cardiac Arrest, Out-of-Hopsital [THAPCA-OH]; NCT00878644). Methods: Baseline functioning was assessed by caregiver responses on the Vineland Adaptive Behavior Scales-Second Edition (VABS-II) soon after OH-CA (based on functioning before OH-CA); children with broadly normal baseline functioning (VABS-II ≥70) were included in the THAPCA-OH primary outcome. VABS-II was completed again 12 months later. Then, face-to-face cognitive evaluations were completed. Analyses evaluated changes in VABS-II composite, domain, and subdomain scores and cognitive functioning at follow-up. Results: Ninety-six of 295 enrolled children were alive at 12 months; 87 of 96 had broadly normal baseline functioning (VABS-II ≥70). Follow-up was obtained on 85/87. Forty-two of 85 had VABS-II ≥70 at 12 months. VABS-II composite, domain, and subdomain scores declined significantly between baseline and 12-month follow-up (P <.001). Declines were greatest in older children. Most children displayed well below average cognitive functioning. Older age at cardiac arrest and higher baseline VABS-II scores were predictive of greater decline in neurobehavioral function. Treatment with hypothermia did not influence neurobehavioral outcomes. Conclusions: This is the largest study exploring long-term neurobehavioral outcomes in children surviving OH-CA who were comatose after resuscitation. Results revealed significant neurobehavioral morbidity across multiple functional domains, based both on caregiver reports and performance on Objective cognitive measures, in survivors 1 year later.
AB - Objective: This study examined 12-month neurobehavioral outcomes in children who survived out-of-hospital cardiac arrest (OH-CA), were comatose after resuscitation, and were enrolled in a clinical trial to evaluate targeted temperature management to hypothermia (33.0°C) or normothermia (36.8°C) (Therapeutic Hypothermia after Pediatric Cardiac Arrest, Out-of-Hopsital [THAPCA-OH]; NCT00878644). Methods: Baseline functioning was assessed by caregiver responses on the Vineland Adaptive Behavior Scales-Second Edition (VABS-II) soon after OH-CA (based on functioning before OH-CA); children with broadly normal baseline functioning (VABS-II ≥70) were included in the THAPCA-OH primary outcome. VABS-II was completed again 12 months later. Then, face-to-face cognitive evaluations were completed. Analyses evaluated changes in VABS-II composite, domain, and subdomain scores and cognitive functioning at follow-up. Results: Ninety-six of 295 enrolled children were alive at 12 months; 87 of 96 had broadly normal baseline functioning (VABS-II ≥70). Follow-up was obtained on 85/87. Forty-two of 85 had VABS-II ≥70 at 12 months. VABS-II composite, domain, and subdomain scores declined significantly between baseline and 12-month follow-up (P <.001). Declines were greatest in older children. Most children displayed well below average cognitive functioning. Older age at cardiac arrest and higher baseline VABS-II scores were predictive of greater decline in neurobehavioral function. Treatment with hypothermia did not influence neurobehavioral outcomes. Conclusions: This is the largest study exploring long-term neurobehavioral outcomes in children surviving OH-CA who were comatose after resuscitation. Results revealed significant neurobehavioral morbidity across multiple functional domains, based both on caregiver reports and performance on Objective cognitive measures, in survivors 1 year later.
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U2 - 10.1542/peds.2015-3412
DO - 10.1542/peds.2015-3412
M3 - Article
C2 - 26940987
AN - SCOPUS:84962543743
SN - 0031-4005
VL - 137
JO - Pediatrics
JF - Pediatrics
IS - 4
ER -