TY - JOUR
T1 - Neurobehavioural outcomes in children after In-Hospital cardiac arrest
AU - on behalf of the Therapeutic Hypothermia after Paediatric Cardiac Arrest (THAPCA) Trial Investigators
AU - Slomine, Beth S.
AU - Silverstein, Faye S.
AU - Christensen, James R.
AU - Holubkov, Richard
AU - Telford, Russell
AU - Dean, J. Michael
AU - Moler, Frank W.
N1 - Funding Information:
A. Topjian (PI), R. Berg (Sub-I), V. Nadkarni (Sub-I), A. Zuppa (Sub-I), J. Fitzgerald (Sub-I), P. Meaney (Sub-I), M. DiLiberto (CRC), C. Twelves (CRC), S. McGowan (CRC), M. Sisko (CRC), B. Park (CRC), N. Hattiangadi Thomas (Psychologist), K. Friedman (Psychologist)The project described was supported by the National Center for Research Resources and the National Center 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:
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).
Funding Information:
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 Development (NICHD), Bethesda, MD. HD044955 (FWM) and HD050531 (FWM).
Funding Information:
“Research reported in this publication was supported by the National Center for AdvancingTranslational Sciences of the National Institutes of Health under Award Numbers UL1 RR024986 and UL1 TR 000433. The content is solely the responsibility of the authors and does notnecessarily represent the official views of the National Institutes of Health.”
Funding Information:
J. Berger (PI), D. Wessel (Sub- I), M. Sharron (Sub-I), S. Basu (Sub-I), A. Wratney (Sub-I), N. Dean (Sub-I), J. Reardon (CRC), E. Tomanio (CRC), J. Carpenter (Neurologist), S. Swanson (Psychologist), T. Brennan (Psychologist), P. Glass (Psychologist), B. Malek (Psychologist), M. Mintz (Psychologist) Our follow ups were conducted in the Clinical Research Center which is supported by NIH P30HD040677Medical College of Wisconsin, Milwaukee, WIM. T. Meyer (PI), M. Wakeham (Sub-I), S. Hanson (Sub-I), K. Murkowski (CRC)
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 Center 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 - 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.
AB - 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.
KW - Cardiac arrest
KW - Cognition
KW - In-hospital cardiac arrest
KW - Neurobehavioral
KW - Outcome
KW - Pediatrics
UR - http://www.scopus.com/inward/record.url?scp=85041678056&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85041678056&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2018.01.002
DO - 10.1016/j.resuscitation.2018.01.002
M3 - Article
C2 - 29305927
AN - SCOPUS:85041678056
SN - 0300-9572
VL - 124
SP - 80
EP - 89
JO - Resuscitation
JF - Resuscitation
ER -