Paediatric in-hospital cardiac arrest: Factors associated with survival and neurobehavioural outcome one year later

Kathleen Meert, Russell Telford, Richard Holubkov, Beth S. Slomine, James R. Christensen, John Berger, George Ofori-Amanfo, Christopher J.L. Newth, J. Michael Dean, Frank W. Moler

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)96-105
Number of pages10
JournalResuscitation
Volume124
DOIs
StatePublished - Mar 1 2018

Fingerprint

Pediatric Hospitals
Psychological Adaptation
Heart Arrest
Thorax
Lactic Acid
Extracorporeal Membrane Oxygenation
Coma
Epinephrine
Induced Hypothermia
Artificial Respiration
Resuscitation
Pediatrics

Keywords

  • In-hospital cardiac arrest
  • Neurobehavioural outcome
  • Paediatric

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

Meert, K., Telford, R., Holubkov, R., Slomine, B. S., Christensen, J. R., Berger, J., ... Moler, F. W. (2018). Paediatric in-hospital cardiac arrest: Factors associated with survival and neurobehavioural outcome one year later. Resuscitation, 124, 96-105. https://doi.org/10.1016/j.resuscitation.2018.01.013

Paediatric in-hospital cardiac arrest : Factors associated with survival and neurobehavioural outcome one year later. / Meert, Kathleen; Telford, Russell; Holubkov, Richard; Slomine, Beth S.; Christensen, James R.; Berger, John; Ofori-Amanfo, George; Newth, Christopher J.L.; Dean, J. Michael; Moler, Frank W.

In: Resuscitation, Vol. 124, 01.03.2018, p. 96-105.

Research output: Contribution to journalArticle

Meert, K, Telford, R, Holubkov, R, Slomine, BS, Christensen, JR, Berger, J, Ofori-Amanfo, G, Newth, CJL, Dean, JM & Moler, FW 2018, 'Paediatric in-hospital cardiac arrest: Factors associated with survival and neurobehavioural outcome one year later', Resuscitation, vol. 124, pp. 96-105. https://doi.org/10.1016/j.resuscitation.2018.01.013
Meert, Kathleen ; Telford, Russell ; Holubkov, Richard ; Slomine, Beth S. ; Christensen, James R. ; Berger, John ; Ofori-Amanfo, George ; Newth, Christopher J.L. ; Dean, J. Michael ; Moler, Frank W. / Paediatric in-hospital cardiac arrest : Factors associated with survival and neurobehavioural outcome one year later. In: Resuscitation. 2018 ; Vol. 124. pp. 96-105.
@article{62713b44ea8e439cb97cd4d9088db3ab,
title = "Paediatric in-hospital cardiac arrest: Factors associated with survival and neurobehavioural outcome one year later",
abstract = "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.",
keywords = "In-hospital cardiac arrest, Neurobehavioural outcome, Paediatric",
author = "Kathleen Meert and Russell Telford and Richard Holubkov and Slomine, {Beth S.} and Christensen, {James R.} and John Berger and George Ofori-Amanfo and Newth, {Christopher J.L.} and Dean, {J. Michael} and Moler, {Frank W.}",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.resuscitation.2018.01.013",
language = "English (US)",
volume = "124",
pages = "96--105",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

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.

PY - 2018/3/1

Y1 - 2018/3/1

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

UR - http://www.scopus.com/inward/record.url?scp=85040327556&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040327556&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2018.01.013

DO - 10.1016/j.resuscitation.2018.01.013

M3 - Article

AN - SCOPUS:85040327556

VL - 124

SP - 96

EP - 105

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -