Faculty Collaboration Database

Neurobehavioral Outcomes in Children After Out-of-Hospital Cardiac Arrest. Pediatrics 2016 Apr;137(4)

Date

03/05/2016

Pubmed ID

26940987

Pubmed Central ID

PMC5051148

DOI

10.1542/peds.2015-3412

Scopus ID

2-s2.0-84962543743 (requires institutional sign-in at Scopus site)   57 Citations

Abstract

OBJECTIVE: This study examined 12-month neurobehavioral outcomes in children who survived out-of-hospital cardiac arrest (OH-CA), were comatose after resuscitation, and were enrolled in a clinical trial to evaluate targeted temperature management to hypothermia (33.0°C) or normothermia (36.8°C) (Therapeutic Hypothermia after Pediatric Cardiac Arrest, Out-of-Hopsital [THAPCA-OH]; NCT00878644).

METHODS: Baseline functioning was assessed by caregiver responses on the Vineland Adaptive Behavior Scales-Second Edition (VABS-II) soon after OH-CA (based on functioning before OH-CA); children with broadly normal baseline functioning (VABS-II ≥70) were included in the THAPCA-OH primary outcome. VABS-II was completed again 12 months later. Then, face-to-face cognitive evaluations were completed. Analyses evaluated changes in VABS-II composite, domain, and subdomain scores and cognitive functioning at follow-up.

RESULTS: Ninety-six of 295 enrolled children were alive at 12 months; 87 of 96 had broadly normal baseline functioning (VABS-II ≥70). Follow-up was obtained on 85/87. Forty-two of 85 had VABS-II ≥70 at 12 months. VABS-II composite, domain, and subdomain scores declined significantly between baseline and 12-month follow-up (P < .001). Declines were greatest in older children. Most children displayed well below average cognitive functioning. Older age at cardiac arrest and higher baseline VABS-II scores were predictive of greater decline in neurobehavioral function. Treatment with hypothermia did not influence neurobehavioral outcomes.

CONCLUSIONS: This is the largest study exploring long-term neurobehavioral outcomes in children surviving OH-CA who were comatose after resuscitation. Results revealed significant neurobehavioral morbidity across multiple functional domains, based both on caregiver reports and performance on objective cognitive measures, in survivors 1 year later.

Author List

Slomine BS, Silverstein FS, Christensen JR, Holubkov R, Page K, Dean JM, Moler FW, THAPCA Trial Group

Author

Michael T. Meyer MD Chief, Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Aptitude Tests
Child
Child, Preschool
Cognition Disorders
Coma
Female
Follow-Up Studies
Humans
Hypothermia, Induced
Infant
Infant, Newborn
Male
Neurodevelopmental Disorders
Neuropsychological Tests
Out-of-Hospital Cardiac Arrest
Survivors