How can neurological outcomes be predicted in comatose pediatric patients after out-of-hospital cardiac arrest?

Abstract

The prognosis of patients who are comatose after resuscitation remains uncertain. The accurate prediction of neurological outcome is important for management decisions and coun seling. A neurological examination is an important factor for prognosti cation, but widely used sedatives alter the neurolo gical examina tion and delay the response recovery. Additional studies inclu ding electroencephalography, somatosen sory evoked potentials, brain imaging, and blood bio markers are useful for evaluating the extent of brain injury. This review aimed to assess the usefulness of and provide practical progno stic strategy for pediatric post resuscita tion pati ents. The prin ciples of prognostication are that the assessment should be delay ed until at least 72 hours after cardiac arrest and the asse ssment should be multimodal. Furthermore, multiple factors including unmeasured confoun ders in indi vidual patients should be considered when applying the prog nostication strategy.

Targeted temperature management and neuroprotective outcomes of pediatric patients after cardiac arrest

“…9) The assessment for the prognostication should be multimodal and delayed until at least 72 hours after cardiac arrest. 10) Many unanswered questions remain regarding the ideal evaluation of TTM in pediatric neurocritical care, such as different durations and cooling depths, earlier TTM onset, and adjunctive neuroprotective agents. Physicians must recognize that the prognostic factors should be monitored during the first 3 phases of pediatric post-cardiac arrest and consider the appropriate therapeutic intervention to provide potential neuroprotection.…”