Extracorporeal Cardiopulmonary Resuscitation: One-Year Survival and Neurobehavioral Outcome Among Infants and Children With In-Hospital Cardiac Arrest*

Meert, Kathleen L.; Guerguerian, Anne Marie; Barbaro, Ryan P.; Slomine, Beth S.; Christensen, James R.; Berger, John; Topjian, Alexis; Bembea, Melania M.; Tabbutt, Sarah; Fink, Ericka L.; Telford, Russell; Dean, J. Michael; Moler, Frank W.

doi:10.1097/ccm.0000000000003545

Cited by 41 publications

(25 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a multicenter randomized trial of therapeutic hypothermia after IHCA, only 30.5% of patients who received ECPR for IHCA had good neurobehavioral outcomes at 12 months of age. 51 In patients who received ECPR, therapeutic hypothermia, compared with normothermia, tended to be associated with lower survival with good neurobehavioral outcome at 1 year. 51 Single-center analyses lack consistency in reported measures of neurologic function/status yet demonstrate favorable neurologic outcomes for the majority of survivors at follow-up (median range, 25-52 months).…”

Section: Expertise and Equipment (Class Iib Loe [Level Of Evidence]mentioning

confidence: 89%

“…[46][47][48] Our understanding of neurologic function after resuscitation with ECPR consists of single-center follow-up analyses 49,50 and the results of a randomized prospective trial of therapeutic hypothermia after IHCA. 51 There is insufficient information about neurologic complications and outcomes (ie, hemorrhagic/ischemic stroke, seizure) associated with the use of ECPR in infants and children. In a multicenter randomized trial of therapeutic hypothermia after IHCA, only 30.5% of patients who received ECPR for IHCA had good neurobehavioral outcomes at 12 months of age.…”

Section: Expertise and Equipment (Class Iib Loe [Level Of Evidence]mentioning

confidence: 99%

See 1 more Smart Citation

2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Duff¹,

Topjian²,

Berg³

et al. 2020

Pediatrics

View full text Add to dashboard Cite

This 2019 focused update to the American Heart Association pediatric advanced life support guidelines follows the 2018 and 2019 systematic reviews performed by the Pediatric Life Support Task Force of the International Liaison Committee on Resuscitation. It aligns with the continuous evidence review process of the International Liaison Committee on Resuscitation, with updates published when the International Liaison Committee on Resuscitation completes a literature review based on new published evidence. This update provides the evidence review and treatment recommendations for advanced airway management in pediatric cardiac arrest, extracorporeal cardiopulmonary resuscitation in pediatric cardiac arrest, and pediatric targeted temperature management during post-cardiac arrest care. The writing group analyzed the systematic reviews and the original research published for each of these topics. For airway management, the writing group concluded that it is reasonable to continue bag-mask ventilation (versus attempting an advanced airway such as endotracheal intubation) in patients with out-of-hospital cardiac arrest. When extracorporeal membrane oxygenation protocols and teams are readily available, extracorporeal cardiopulmonary resuscitation should be considered for patients with cardiac diagnoses and in-hospital cardiac arrest. Finally, it is reasonable to use targeted temperature management of 32°C to 34°C followed by 36°C to 37.5°C, or to use targeted temperature management of 36°C to 37.5°C, for pediatric patients who remain comatose after resuscitation from out-of-hospital cardiac arrest or in-hospital cardiac arrest. This 2019 focused update to the American Heart Association (AHA) pediatric advanced life support (PALS) guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care (ECC) is based on 3 systematic reviews 1-3 and the resulting

show abstract

Section: Expertise and Equipment (Class Iib Loe [Level Of Evidence]mentioning

confidence: 89%

Section: Expertise and Equipment (Class Iib Loe [Level Of Evidence]mentioning

confidence: 99%

2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Duff¹,

Topjian²,

Berg³

et al. 2020

Pediatrics

View full text Add to dashboard Cite

show abstract

“…During ECPR, an extracorporeal circuit is established to maintain vital organ perfusion until potentially reversible causes of cardiac arrest are identified and treated. Survival to hospital discharge after ECPR is about 40% [1,2]; however, long-term cognitive and neurologic outcomes among survivors are largely unknown [3][4][5][6]. Knowledge regarding these outcomes is important for clinical decision-making, counselling parents, and planning rehabilitation and educational services during recovery.…”

Section: Introductionmentioning

confidence: 99%

“…We previously reported that about a third of children receiving ECPR in the context of the THAPCA-IH trial survived with good neurobehavioral function at one year based on caregiver responses to the VABS-II [3]. Benefits of using a caregiver-report measure included the ability to collect data in-person or by telephone, and to obtain a retrospective assessment of each child's pre-arrest functional status.…”

Section: Introductionmentioning

confidence: 99%

One-year cognitive and neurologic outcomes in survivors of paediatric extracorporeal cardiopulmonary resuscitation

et al. 2019

Self Cite

View full text Add to dashboard Cite

Objective: To describe one-year cognitive and neurologic outcomes among extracorporeal cardiopulmonary resuscitation (ECPR) survivors enrolled in the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial; and compare outcomes between survivors who received ECPR, later extracorporeal membrane oxygenation (ECMO), or no ECMO. Methods: All children recruited to THAPCA-IH were comatose post-arrest. Neurobehavioral function was assessed by caregivers using the Vineland Adaptive Behaviour Scales, 2nd edition (VABS-II) at pre-arrest baseline and 12 months post-arrest. Age-appropriate cognitive performance measures (Mullen Scales of Early Learning or Wechsler Abbreviated Scale of Intelligence) and neurologic examinations were obtained 12 months post-arrest. VABS-II and cognitive performance measures were transformed to standard scores (mean=100, SD=15) with higher scores representing better performance. Only children with broadly normal pre-arrest function (VABS-II ≥70) were included in this analysis. Results: One-year follow-up was attained for 127 survivors with pre-arrest VABS-II ≥70. Of these, 57 received ECPR, 14 received ECMO later in their course, and 56 did not receive ECMO. VABS-II assessments were completed at 12 months for 55 (96.5%) ECPR survivors, cognitive testing for 44 (77.2%) and neurologic examination for 47 (82.5%). At 12 months, 39 (70.9%) ECPR survivors had VABS-II scores ≥70. On cognitive testing, 24 (54.6%) had scores ≥70, and on neurologic examination, 28 (59.5%) had no/minimal to mild impairment. Cognitive and neurologic score distributions were similar between ECPR, later ECMO and no ECMO groups. Conclusions: Many ECPR survivors had favourable outcomes although impairments were common. ECPR survivors had similar outcomes to other survivors who were initially comatose post-arrest.

show abstract

“…Generally, patient’s core body temperature of 33 to 35 °C is maintained for 24–48 h [ 8 ]. Therapeutic hypothermia when compared with normothermia after ECPR is associated with lesser survival with good neurobehavioural outcome at 1-year follow-up [ 23 ].…”

Section: Post-ecpr Managementmentioning

confidence: 99%

ECPR—extracorporeal cardiopulmonary resuscitation

Kumar

2021

Indian J Thorac Cardiovasc Surg

View full text Add to dashboard Cite

Extracorporeal Cardiopulmonary Resuscitation: One-Year Survival and Neurobehavioral Outcome Among Infants and Children With In-Hospital Cardiac Arrest*

Cited by 41 publications

References 46 publications

2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

2019 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

One-year cognitive and neurologic outcomes in survivors of paediatric extracorporeal cardiopulmonary resuscitation

ECPR—extracorporeal cardiopulmonary resuscitation

Contact Info

Product

Resources

About