Long-term neurologic outcomes following paediatric out-of-hospital cardiac arrest

Michiels, Erica A.; Quan, Linda; Dumas, Florence; Rea, Thomas D.

doi:10.1016/j.resuscitation.2016.01.010

Cited by 20 publications

(15 citation statements)

References 25 publications

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“…In this study, we assessed the proportions of pediatric patients with a PCPC score of 1 or 2 at 1 month and 90 days after OHCA occurrence and found they were similar. In a previous study comparing PCPC scores at discharge with those at the final follow-up in children with OHCA, 94% of patients were discharged with a PCPC score of 1 or 2 and maintained the score, while 54% were discharged with a PCPC score of 3-5 and died at the final follow-up, 25) which suggest that an improvement in the PCPC score at an early phase after OHCA occurrence would be important for better long-term outcome in children with OHCA. However, the improvement of procedures after hospital arrival would be important in the future.…”

Section: Discussionmentioning

confidence: 96%

Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

et al. 2020

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The effect of post-cardiac arrest care in children with out-of-hospital cardiac arrest (OHCA) has not been adequately established, and the long-term outcome after pediatric OHCA has not been sufficiently investigated. We describe here detailed in-hospital characteristics, actual management, and survival, including neurological status, 90 days after OHCA occurrence in children with OHCA transported to critical care medical centers (CCMCs). We analyzed the database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITI-CAL) study, which is a multicenter, prospective observational data registry designed to accumulate both preand in-hospital data on OHCA treatments. We enrolled all consecutive pediatric patients aged <18 years who had an OHCA and for whom resuscitation was attempted and who were transported to CCMCs between 2012 and 2016. A total of 263 pediatric patients with OHCA were enrolled. The average age of the patients was 6.3 years, 38.0% were aged < 1 year, and 60.8% were male. After hospital arrival, 4.9% of these pediatric patients received defibrillation; 1.9%, extracorporeal life support; 6.5%, target temperature management; and 88.2% adrenaline administration. The proportions of patients with 90-day survival and a pediatric cerebral performance category (PCPC) score of 1 or 2 were 6.1% and 1.9%, respectively. The proportion of patients with a PCPC score of 1 or 2 at 90 days after OHCA occurrence did not significantly improve during the study period. The proportion of pediatric patients with a 90-day PCPC score of 1 or 2 transported to CCMCs was extremely low, and no significant improvements were observed during the study period.

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Section: Discussionmentioning

confidence: 96%

Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

et al. 2020

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“…It is relatively common among children, especially those younger than 3 years, because they have a high risk of aspirating foreign bodies owing to their tendency to place objects in their mouth and lack of a well-developed swallowing re ex [3][4][5][6]. Moreover, the neurological outcome a er OHCA in pediatric patients remains generally poor [7][8][9][10]. Here, we report an unusual pediatric case of asphyxial OHCA caused by foreign bodies obstructing the airway, complicating esophageal foreign body, with a neurologically favorable outcome.…”

Section: Introductionmentioning

confidence: 99%

Successful Management of Airway and Esophageal Foreign Body Obstruction in a Child

Yogo

Toida

Muguruma

et al. 2019

Case Reports in Emergency Medicine

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Foreign body asphyxia is a serious clinical problem with high morbidity and mortality rates. It is relatively common among children, especially those younger than 3 years, because they have a high risk of aspirating foreign bodies owing to their tendency to place objects in their mouth and lack of a well-developed swallowing reflex. Moreover, the neurologic outcome after out-of-hospital cardiac arrests (OHCA) in pediatric patients remains generally poor. Here, we report an unusual pediatric case of asphyxial OHCA caused by foreign bodies obstructing the airway, complicating esophageal foreign body, with a neurologically favorable outcome. This case highlights the importance of adequate treatment for pediatric patients with OHCA, as well as the prompt and efficient management for pediatric patients with foreign bodies obstructing the airway and esophagus.

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“…Eleven children had improved neurologic function over the years, and three transitioned from a severe disability category (PCPC 4) to a favorable neurologic status (PCPC 1 or 2). 13 These observations suggest that some children whose initial neurologic assessment indicates a moderate to severe brain injury may be able to recover significant neurologic function. Four children who were categorized as having a favorable neurologic outcome had a decline in their neurologic status, and two transitioned into an unfavorable category.…”

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confidence: 96%

“…[9][10][11][12] In this issue of Resuscitation, Michiels and colleagues report the long-term neurologic status of children who survived OHCA from January 1976 to December 2007. 13 They retrospectively determined the PCPC score of 91 children based on chart review of the "history and physical examination" at the time of hospital discharge from their OHCA and then again after subsequent hospital admissions or clinic visits. We applaud the efforts of the investigators for undertaking this challenging and laborious task.…”

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confidence: 99%

“…Four children who were categorized as having a favorable neurologic outcome had a decline in their neurologic status, and two transitioned into an unfavorable category. 13 This may be due to the phenomena that some deficits become evident as children mature and fail to meet developmental or scholastic expectations or that morbidities worsen over time. Transitions in each direction highlight the challenges and imprecisions in predicting long-term neurologic abilities at the time of hospital discharge following an OHCA.…”

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confidence: 99%

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