Jainn-Jim Lin1, Chia-Ying Lin2, Shao-Hsuan Hsia2, Huei-Shyong Wang3, Ming-Chou Chiang4, Kuang-Lin Lin5. 1. Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan, Taiwan; Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 2. Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 3. Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. 4. Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan, Taiwan; Division of Neonatology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Study Group for Intensive and Integrated Care of Pediatric Central Nervous System, Chang Gung Children's Hospital, Taoyuan, Taiwan. 5. Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan. Electronic address: lincgh@adm.cgmh.org.tw.
Abstract
BACKGROUND: Recent studies suggest that a 48-h therapeutic hypothermia protocol does not improve outcomes in paediatric out-of-hospital cardiac arrest survivors. The aim of this study was to evaluate the effect of 72-h therapeutic hypothermia at 33 °C compared to normothermia at 35.5 °C-37.5 °C on outcomes and the incidence of adverse events in paediatric asphyxial out-of-hospital cardiac arrest survivors. METHODS: We conducted this retrospective cohort study at a tertiary paediatric intensive care unit between January 2010 and June 2017. All children from 1 month to 18 years of age with asphyxial out-of-hospital cardiac arrest and a history of at least 3 min of chest compressions who survived for 12 h or more after the return of circulation were eligible. RESULTS: Sixty-four patients met the eligibility criteria for the study. Forty-nine (76.6%) of the 64 children were male, and the mean age was 4.86+/-5.26 years. Twenty-four (37.5%) of the children had underlying disorders. The overall 1-month survival rate was 43.2%. Twenty-five (39.1%) of the children received therapeutic hypothermia at 33 °C for 72 h. The 1-month survival rate was significantly higher (p = 0.037) in the therapeutic hypothermia group (15/25, 60%) than in the normothermia group (12/39, 30.8%). The therapeutic hypothermia group had significantly better neurological outcomes (7/15, 46.7%) than the normothermia group (1/12, 8.3%) (p = 0.043). CONCLUSION: Paediatric asphyxial out-of-hospital cardiac arrest was associated with high mortality and morbidity. Seventy-two-hour therapeutic hypothermia was associated with a better 1-month survival rate and 6-month neurological outcomes than normothermia in our paediatric patients with asphyxial out-of-hospital cardiac arrest.
BACKGROUND: Recent studies suggest that a 48-h therapeutic hypothermia protocol does not improve outcomes in paediatric out-of-hospital cardiac arrest survivors. The aim of this study was to evaluate the effect of 72-h therapeutic hypothermia at 33 °C compared to normothermia at 35.5 °C-37.5 °C on outcomes and the incidence of adverse events in paediatric asphyxial out-of-hospital cardiac arrest survivors. METHODS: We conducted this retrospective cohort study at a tertiary paediatric intensive care unit between January 2010 and June 2017. All children from 1 month to 18 years of age with asphyxial out-of-hospital cardiac arrest and a history of at least 3 min of chest compressions who survived for 12 h or more after the return of circulation were eligible. RESULTS: Sixty-four patients met the eligibility criteria for the study. Forty-nine (76.6%) of the 64 children were male, and the mean age was 4.86+/-5.26 years. Twenty-four (37.5%) of the children had underlying disorders. The overall 1-month survival rate was 43.2%. Twenty-five (39.1%) of the children received therapeutic hypothermia at 33 °C for 72 h. The 1-month survival rate was significantly higher (p = 0.037) in the therapeutic hypothermia group (15/25, 60%) than in the normothermia group (12/39, 30.8%). The therapeutic hypothermia group had significantly better neurological outcomes (7/15, 46.7%) than the normothermia group (1/12, 8.3%) (p = 0.043). CONCLUSION: Paediatric asphyxial out-of-hospital cardiac arrest was associated with high mortality and morbidity. Seventy-two-hour therapeutic hypothermia was associated with a better 1-month survival rate and 6-month neurological outcomes than normothermia in our paediatric patients with asphyxial out-of-hospital cardiac arrest.
Authors: Jennifer B Brandt; Sabine Steiner; Gerald Schlager; Kambis Sadeghi; Regina Vargha; Johann Golej; Michael Hermon Journal: Acta Paediatr Date: 2020-08-12 Impact factor: 2.299
Authors: Wojciech Wieczorek; Jarosław Meyer-Szary; Milosz J Jaguszewski; Krzysztof J Filipiak; Maciej Cyran; Jacek Smereka; Aleksandra Gasecka; Kurt Ruetzler; Lukasz Szarpak Journal: J Clin Med Date: 2021-03-30 Impact factor: 4.241