Literature DB >> 30818016

One-year cognitive and neurologic outcomes in survivors of paediatric extracorporeal cardiopulmonary resuscitation.

Kathleen Meert1, Beth S Slomine2, Faye S Silverstein3, James Christensen2, Rebecca Ichord4, Russell Telford5, Richard Holubkov5, J Michael Dean5, Frank W Moler6.   

Abstract

OBJECTIVE: To describe one-year cognitive and neurologic outcomes among extracorporeal cardiopulmonary resuscitation (ECPR) survivors enrolled in the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial; and compare outcomes between survivors who received ECPR, later extracorporeal membrane oxygenation (ECMO), or no ECMO.
METHODS: All children recruited to THAPCA-IH were comatose post-arrest. Neurobehavioral function was assessed by caregivers using the Vineland Adaptive Behaviour Scales, 2nd edition (VABS-II) at pre-arrest baseline and 12 months post-arrest. Age-appropriate cognitive performance measures (Mullen Scales of Early Learning or Wechsler Abbreviated Scale of Intelligence) and neurologic examinations were obtained 12 months post-arrest. VABS-II and cognitive performance measures were transformed to standard scores (mean = 100, SD = 15) with higher scores representing better performance. Only children with broadly normal pre-arrest function (VABS-II ≥70) were included in this analysis.
RESULTS: One-year follow-up was attained for 127 survivors with pre-arrest VABS-II ≥70. Of these, 57 received ECPR, 14 received ECMO later in their course, and 56 did not receive ECMO. VABS-II assessments were completed at 12 months for 55 (96.5%) ECPR survivors, cognitive testing for 44 (77.2%) and neurologic examination for 47 (82.5%). At 12 months, 39 (70.9%) ECPR survivors had VABS-II scores ≥70. On cognitive testing, 24 (54.6%) had scores ≥70, and on neurologic examination, 28 (59.5%) had no/minimal to mild impairment. Cognitive and neurologic score distributions were similar between ECPR, later ECMO and no ECMO groups.
CONCLUSIONS: Many ECPR survivors had favourable outcomes although impairments were common. ECPR survivors had similar outcomes to other survivors who were initially comatose post-arrest.
Copyright © 2019 Elsevier B.V. All rights reserved.

Entities:  

Keywords:  Cognitive; Extracorporeal cardiopulmonary resuscitation; Neurobehavioral; Neurologic; Outcome; Paediatric

Mesh:

Year:  2019        PMID: 30818016      PMCID: PMC6574085          DOI: 10.1016/j.resuscitation.2019.02.023

Source DB:  PubMed          Journal:  Resuscitation        ISSN: 0300-9572            Impact factor:   5.262


  18 in total

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