Author Of 1 Presentation
5 YEARS SURVIVAL, PERFORMANCE AND NEURODEVELOPMENTAL OUTCOME FOLLOWING CARDIOPULMONARY RESUSCITATION AFTER PEDIATRIC CARDIAC SURGERY
Abstract
Background
Children who suffer cardiopulmonary arrest (CPA) after cardiac surgery frequently survive with return of spontaneous circulation (ROSC). However, their neurodevelopmental outcomes and performance are still unclear.
Objectives
The aim of this study is to evaluate the midterm neurodevelopmental and performance of children who survived CPA following cardiac surgery.
Methods
We followed up children who received CPR post cardiac surgery during 2012-2013. We assessed their 5 years survival, functional and neurodevelopmental outcomes using two performance scales: Pediatric Cerebral Performance Category (PCPC) and Pediatric Overall Performance Category (POPC). Both scales range from (1) for normal until (6) for brain death/death. We compared CPR group to a matching comparable group (1:1) that had no CPA or CPR.
Results
15 out of 758 (2%) post-operative cardiac children, had 19 episodes of CPA. Median age was 10 months (0.5-168). Survival rates were 12/15 (80%) on hospital discharge and 10/15 (66%) after 5 years. Among 12 survivors, 2 patients (17%) scored 6, 1 (8%) scored 4, 5 (42%) scored 2, and 4 (33%) scored 1 on both PCPC and POPC. The median PCPC and POPC scores were (2, [interquartile range: 1 to 6] and 1, [interquartile range: 1 to 3], P= 0.018) for CPR and matching group respectively. Regression analysis identifies duration of CPR, number of CPR session and late occuring CPA as risk factors for poor outcome.
Conclusion
2/3 of children requiring CPR post cardiac surgery survived after 5 years. Neurodevelopmentally, they demonstrated worse outcome. CPR duration, number of CPA events and late CPA were risk factors for poor outcome.