Outcome Following Cardiopulmonary Arrest

Haque, Ikram U.; Udassi, Jai P.; Zaritsky, Arno

doi:10.1016/j.pcl.2008.04.008

Cited by 19 publications

(17 citation statements)

References 68 publications

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“…Assessment of neurologic function may be unreliable immediately following resuscitation after cardiopulmonary arrest [30][31][32][33] or other acute brain injuries and serial neurologic examinations are necessary to establish or refute the diagnosis of brain death. Additionally, initial stabilization may take several hours during which time correcting metabolic disturbances and identifying and treating reversible conditions that may imitate brain death can be accomplished.…”

Section: Prerequisites For Initiating a Clinical Brain Death Evaluatimentioning

confidence: 99%

Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations

Nakagawa¹,

Ashwal²,

Mathur³

et al. 2011

Pediatrics

183

120

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OBJECTIVE: To review and revise the 1987 pediatric brain death guidelines. METHODS: Relevant literature was reviewed. Recommendations were developed using the GRADE system. CONCLUSIONS AND RECOMMENDATIONS: (1) Determination of brain death in term newborns, infants and children is a clinical diagnosis based on the absence of neurologic function with a known irreversible cause of coma. Because of insufficient data in the literature, recommendations for preterm infants less than 37 weeks gestational age are not included in this guideline.

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Section: Prerequisites For Initiating a Clinical Brain Death Evaluatimentioning

confidence: 99%

Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations

Nakagawa¹,

Ashwal²,

Mathur³

et al. 2011

Pediatrics

183

120

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“…Laboratory values such as severe acidotic pH-values, high blood sugar and lactate are usually signs of a long submersion and resuscitation time and therefore they are signs of poor outcome except in hypothermic children drowned in icy water [7,10,27,32-36]. There are insufficient data on biochemical markers such as neuron-specific enolase (NSE) or serum astroglial protein (S-100B) in children after cardiac arrest to help outcome prediction [31]. …”

Section: Methodsmentioning

confidence: 99%

“…Clinical assessment in the PICU is also often compromised by factors that include: sedation, neuromuscular blockade, ventilation, hypothermia and inotropic management [30,31]. The presence of any motor activity and pupillary reactivity noted on arrival to the ER could significantly discriminate between survivors and fatalities, but could not discriminate between intact and vegetative survivors [6].…”

Section: Methodsmentioning

confidence: 99%

“…The degree of edema and brain swelling is better seen by MRI than by computer tomography (CT) scans, therefore CT scans are not widely used for early outcome prediction [31]. In the European resuscitation council guidelines for resuscitation, it is recommended to consider induced hypothermia for 12 – 24 hours for children who remain comatose following resuscitation, although there is no strong scientific evidence in the literature to support this treatment of children [39].…”

Section: Methodsmentioning

confidence: 99%

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Neurologic long term outcome after drowning in children

Suominen

Vähätalo

2012

Scand J Trauma Resusc Emerg Med

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Drowning is a major source of mortality and morbidity in children worldwide. Neurocognitive outcome of children after drowning incidents cannot be accurately predicted in the early course of treatment. Therefore, aggressive out-of-hospital and in-hospital treatment is emphasized. There are "miracle" cases after long submersion times that have been reported in the medical literature, which mostly concern small children. However, many of the survivors will remain severely neurologically compromised after remarkably shorter submersion times and will consequently be a great burden to their family and society for the rest of their lives. The duration of submersion, the need of advanced life support at the site of the accident, the duration of cardiopulmonary resuscitation, whether spontaneous breathing and circulation are present on arrival at the emergency room are important factors related to survival with mild neurological deficits or intact function in drowned children. Data on long-term outcome are scarce. The used outcome measurement methods and the duration of follow-up have not been optimal in most of the existing studies. Proper neurological and neurophysiological examinations for drowned children are superior to outcome scales based chart reviews. There is evidence that gross neurological examination at the time of discharge from the hospital in young children does not reveal all the possible sequelae related to hypoxic brain injury and thus long-term follow-up of drowned resuscitated children is strongly recommended.

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“…Birth asphyxia has various etiologies including CA and infection, and some infants in these studies were premature, who are known to have similar (basal ganglia and thalamus) and different (premature infants are more susceptible to intraventricular hemorrhage and leukomalacia) regions of brain especially vulnerable to hypoxia-ischemia as well as developmentally-related differences in baseline brain imaging findings compared to older infants and children [45]. Infants and children surviving CA frequently have basal ganglia and cortical injury, and prospective imaging studies that examined patterns of injury and longer-term neurological outcome are needed in children with acute brain injury [25,59]. …”

Section: How Might Hypothermia Affect Specific Rehabilitation Needs?mentioning

confidence: 99%

Acute brain injury and therapeutic hypothermia in the PICU: A rehabilitation perspective

Fink

Beers

Russell

et al. 2009

Journal of Pediatric Rehabilitation Medicine

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Acquired brain injury from traumatic brain injury, cardiac arrest (CA), stroke, and central nervous system infection is a leading cause of morbidity and mortality in the pediatric population and admission to inpatient rehabilitation. Therapeutic hypothermia is the only intervention shown to have efficacy from bench to bedside in improving neurological outcome after birth asphyxia and adult arrhythmia-induced CA, thought to be due to its multiple mechanisms of action. Research to determine if therapeutic hypothermia should be applied to other causes of brain injury and how to best apply it is underway in children and adults. Changes in clinical practice in the hospitalized brain-injured child may have effects on rehabilitation referral practices, goals and strategies of therapies offered, and may increase the degree of complex medical problems seen in children referred to inpatient rehabilitation.

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Outcome Following Cardiopulmonary Arrest

Cited by 19 publications

References 68 publications

Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations

Guidelines for the Determination of Brain Death in Infants and Children: An Update of the 1987 Task Force Recommendations

Neurologic long term outcome after drowning in children

Acute brain injury and therapeutic hypothermia in the PICU: A rehabilitation perspective

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