TY  - JOUR
PY  - 2017//
TI  - Pediatric cardiac arrest due to drowning and other respiratory etiologies: neurobehavioral outcomes in initially comatose children
JO  - Resuscitation
A1  - Slomine, Beth S.
A1  - Nadkarni, Vinay M.
A1  - Christensen, James R.
A1  - Silverstein, Faye S.
A1  - Telford, Russell
A1  - Topjian, Alexis
A1  - Koch, Joshua D.
A1  - Sweney, Jill
A1  - Fink, Ericka L.
A1  - Mathur, Mudit
A1  - Holubkov, Richard
A1  - Dean, J. Michael
A1  - Moler, Frank W.
SP  - 178
EP  - 184
VL  - 115
IS  - 
N2  - AIM: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial. <br><br>METHODS: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2minutes, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36.8°C)] within 6hours of ROC. Neurobehavioral outcomes included 1-year Vineland Adaptive Behavior Scales, Second Edition (VABS-II) total and domain scores and age-appropriate cognitive performance measures (Mullen Scales of Early Learning or Wechsler Abbreviated Scale of Intelligence). <br><br>RESULTS: Sixty-six children with a respiratory etiology of cardiac arrest survived for 1-year; 60/66 had broadly normal premorbid functioning (VABS-II ≥ 70). Follow up was obtained on 59/60 (30 with drowning etiology). VABS-II composite and domain scores declined significantly from premorbid scores in drowning and non-drowning groups (p <0.001), although declines were less pronounced for the drowning group. Seventy-two percent of children had well below average cognitive functioning at 1-year. Younger age, fewer doses of epinephrine, and drowning etiology were associated with better VABS-II composite scores. Demographic variables and treatment with hypothermia did not influence neurobehavioral outcomes. <br><br>CONCLUSIONS: Risks for poor neurobehavioral outcomes were high for children who were comatose after out-of-hospital cardiac arrest due to respiratory etiologies; survivors of drowning had better outcomes than those with other respiratory etiologies.<br><br>Copyright © 2017 Elsevier B.V. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0300-9572
UR  - http://dx.doi.org/10.1016/j.resuscitation.2017.03.007
ID  - ref1
ER  -