Dick Tibboel (Netherlands)
Erasmus MC - Sophia Children's hospital Pediatric surgery/ICUAuthor Of 4 Presentations
CLINICAL PHARMACOLOGY TRIALS DURING ECMO
CHAIRPERSON INTRODUCTION
LONGITUDINAL TWO YEARS EVALUATION OF NEUROPSYCHOLOGICAL OUTCOME IN CHILDREN AFTER OUT OF HOSPITAL CARDIAC ARREST.
Abstract
Background and Aims
To investigate longitudinal functional and neuropsychological outcomes 3-6 and 24 months after pediatric OHCA. Furthermore, the association between pediatric cerebral performance category (PCPC) and neuropsychological outcome was explored.
Methods
Included were children (0-18 years) who experienced OHCA and were admitted to the pediatric intensive care unit (PICU) of a tertiary university hospital between 2012 and 2017. Survivors were assessed during an outpatient multidisciplinary follow-up program 3-6 and 24 months post-OHCA. Outcomes were assessed through interviews, neurologic exam, and validated neuropsychological testing.
Results
One-hundred-thirteen children were admitted to the PICU following return of circulation after OHCA. The most common cause of OHCA was near-drowning (21%). Median age at time of OHCA was 53 months, 64% were male. Fifty-one (45%) survived to hospital discharge. Three to six and 24 months post-OHCA, respectively 74 and 73% had a good PCPC score (1-2). Compared with normative data, lower scores were found on sustained attention and processing speed both at 3-6 (n=26) and at 24 months (n=27) post-OHCA. At 24 months, lower scores were also found on intelligence, selective attention, and cognitive flexibility. In children tested at both time-points (n=19), no significant changes in neuropsychological outcome were found over time. Intelligence scores did not correlate with PCPC.
Conclusions
In the majority of pediatric OHCA survivors PCPC was good 3-6 and 24 months post-arrest. Neuropsychological assessment showed adverse outcome at 3-6 and 24 months. PCPC scores were not associated with intelligence scores. Follow-up should be standardized and continued into adulthood