Pierre Bourgoin1, Victoire Barrault2, Nicolas Joram1, Laurène Leclair Visonneau3, Fréderique Toulgoat4, Emmanuelle Anthoine5, Gauthier Loron6, Alexis Chenouard1. 1. Pediatric Intensive Care Unit, University Hospital, Nantes, France. 2. Department of Pediatrics, University Hospital, Nantes, France. 3. Department of Neurophysiology, University Hospital, Nantes, France. 4. Department of Neuroradiology, University Hospital, Nantes, France. 5. Department of Public Health, University Hospital, Nantes, France. 6. Neonatal and Pediatric Intensive Care Unit, University Hospital, Reims, France.
Abstract
OBJECTIVES: To assess the ability of amplitude-integrated electroencephalography monitoring within 24 hours of the return of spontaneous circulation to prognosticate neurologic outcomes in children following cardiac arrest DESIGN: : Retrospective review of prospectively recorded data. An amplitude-integrated electroencephalography background score was calculated according to background activity during the first 24 hours after return of spontaneous circulation, a higher score correlating with more impaired background activity. The primary endpoint was the neurologic outcome as defined by the Pediatric Cerebral Performance Category at PICU discharge (Pediatric Cerebral Performance Category 1-3: a good neurologic outcome; Pediatric Cerebral Performance Category 4-6: a poor neurologic outcome). SETTING: A referral PICU. PATIENTS: Thirty children with a median age of 10 months (2-38 mo) and a male/female sex ratio of 1.3 were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eighteen patients were assigned to the favorable outcome group and 12 to the unfavorable outcome group. The median time between return of spontaneous circulation and amplitude-integrated electroencephalography initiation was 4 hours (3-9 hr). The amplitude-integrated electroencephalography score within 24 hours after return of spontaneous circulation was significantly higher in the children with poor outcomes compared with those with good outcomes (12 ± 4 vs 25 ± 8; p < 0.001). Background activity during amplitude-integrated electroencephalography monitoring was able to predict poor neurologic outcomes at PICU discharge, with an area under the receiver operating characteristic curve of 0.91 (95% CI, 0.81-1.00). CONCLUSIONS: Early amplitude-integrated electroencephalography monitoring may help predict poor neurologic outcomes in children within 24 hours following cardiac arrest.
OBJECTIVES: To assess the ability of amplitude-integrated electroencephalography monitoring within 24 hours of the return of spontaneous circulation to prognosticate neurologic outcomes in children following cardiac arrest DESIGN: : Retrospective review of prospectively recorded data. An amplitude-integrated electroencephalography background score was calculated according to background activity during the first 24 hours after return of spontaneous circulation, a higher score correlating with more impaired background activity. The primary endpoint was the neurologic outcome as defined by the Pediatric Cerebral Performance Category at PICU discharge (Pediatric Cerebral Performance Category 1-3: a good neurologic outcome; Pediatric Cerebral Performance Category 4-6: a poor neurologic outcome). SETTING: A referral PICU. PATIENTS: Thirty children with a median age of 10 months (2-38 mo) and a male/female sex ratio of 1.3 were included. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Eighteen patients were assigned to the favorable outcome group and 12 to the unfavorable outcome group. The median time between return of spontaneous circulation and amplitude-integrated electroencephalography initiation was 4 hours (3-9 hr). The amplitude-integrated electroencephalography score within 24 hours after return of spontaneous circulation was significantly higher in the children with poor outcomes compared with those with good outcomes (12 ± 4 vs 25 ± 8; p < 0.001). Background activity during amplitude-integrated electroencephalography monitoring was able to predict poor neurologic outcomes at PICU discharge, with an area under the receiver operating characteristic curve of 0.91 (95% CI, 0.81-1.00). CONCLUSIONS: Early amplitude-integrated electroencephalography monitoring may help predict poor neurologic outcomes in children within 24 hours following cardiac arrest.
Authors: Jennifer C Laws; Lori C Jordan; Lindsay M Pagano; John C Wellons; Michael S Wolf Journal: Pediatr Neurol Date: 2022-02-02 Impact factor: 3.372
Authors: Verena T Löffelhardt; Adela Della Marina; Sandra Greve; Hanna Müller; Ursula Felderhoff-Müser; Christian Dohna-Schwake; Nora Bruns Journal: Front Pediatr Date: 2022-01-21 Impact factor: 3.418