Two-year survival and neurodevelopmental outcomes after cardiopulmonary resuscitation in neonatal patients after complex cardiac surgery

Hansen, Gregory; Joffe, Ari R.; Nettel-Aguirre, Alberto; Robertson, Charlene M.T.; Biggs, Wayne S.G.; Rebeyka, Ivan M.

doi:10.1016/j.resuscitation.2010.10.017

Cited by 11 publications

(2 citation statements)

References 21 publications

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“…In the current study, there was no significant impairment of intelligence assessed more than one year after developing transient hypoxic events (less than 60 seconds) during intraoperative or PACU period in non-chronic hypoxic children. Two previous studies of congenital cyanotic cardiac surgery have supported our finding in terms of no differences in neurodevelopment outcome of chronic hypoxia or cardiac arrest children when compared with healthy children or children with no cardiac arrest, respectively (Hövels-Gürich et al 2001 ; Hansen et al 2011 ). However, the reasons why PD itself was not associated with intelligence outcome in our study can be explained as follows.…”

Section: Discussionsupporting

confidence: 87%

Comparison of intelligence, weight and height in children after general anesthesia with and without perioperative desaturation in non-cardiac surgery: a historical and concurrent follow-up study

et al. 2014

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PurposeTo determine whether perioperative desaturation (PD) in preschool children undergoing non-cardiac surgery is associated with subsequent impairment of intelligence or subsequent change in age-specific weight and height percentile.MethodA historical-concurrent follow-up study was conducted in children aged ≤ 60 months who underwent general anesthesia (GA) for non-cardiac surgery between January 2008 and December 2011 at Songklanagarind Hospital. Children who developed PD (PD group) and children who did not develop perioperative respiratory events (no-PRE group) were matched on sex, age, year of having index GA, type of surgery and choice of anesthesia. The children’s age-specific weight and height percentile and intelligence quotient (IQ) scores by Standford Binet-LM or Wechsler Intelligence Scale for Children, 3rd edition 12–60 months after GA were compared using Student’s t- test and Wilcoxon’s rank sum test. Multivariate linear regression models for standardized IQ and multivariate mixed effects linear regression models for the change of age-specific weight and height percentile from the time of index GA to the time of IQ test were performed to identify independent predictors. The coefficients and 95% confidence intervals (CI) were displayed and considered significant if the F test p-values were < 0.05.ResultsOf 103 subjects in each group (PD vs no-PRE), there were no statistically significant differences in IQ (94.7 vs 98.3, p = 0.13), standardized IQ (−0.1 vs 0.1, p = 0.14) or age-specific weight percentile (38th vs 63th, p = 0.06). However, age-specific height percentile in the PD group at the time of IQ test was significantly lower (38th vs 50th, p = 0.02). In the multivariate analysis, PD was not a significant predictor for standardized IQ (coefficient: −0.06, 95% CI: −0.3, 0.19, p = 0.57), change in age-specific weight percentile (coefficient: 4.66, 95% CI: −2.63, 11.95, p = 0.21) or change in age-specific height percentile (coefficient: −1.65, 95% CI: −9.74, 6.44, p = 0.69) from the time of index GA to the time of IQ test after adjusting for family and anesthesia characteristics.ConclusionOur study could not demonstrate any serious effect of PD on subsequent intelligence or on the change in age-specific weight and height percentile of children after non-cardiac surgery.Electronic supplementary materialThe online version of this article (doi:10.1186/2193-1801-3-164) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Comparison of intelligence, weight and height in children after general anesthesia with and without perioperative desaturation in non-cardiac surgery: a historical and concurrent follow-up study

et al. 2014

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“…Following removal of duplicates (n = 496), 2078 studies were screened on titles and abstracts. Of the remaining 344 full-text articles, 25 observational studies were included for the qualitative review, for a total of 131 724 children and 5213 IHCAs (4%) 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ( Figure 1 , Table ). Of the 25 studies included, 23 were cohort studies and 2 were case-control studies.…”

Section: Resultsmentioning

confidence: 99%

Trends in In-Hospital Cardiac Arrest and Mortality Among Children With Cardiac Disease in the Intensive Care Unit

et al. 2023

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ImportanceData on trends in incidence and mortality for in-hospital cardiac arrest (IHCA) in children with cardiac disease in the intensive care unit (ICU) are lacking. Additionally, there is limited information on factors associated with IHCA and mortality in this population.ObjectiveTo investigate incidence, trends, and factors associated with IHCA and mortality in children with cardiac disease in the ICU.Data SourcesA systematic review was conducted using PubMed, Web of Science, EMBASE, and CINAHL, from inception to September 2021.Study SelectionObservational studies on IHCA in pediatric ICU patients with cardiac disease were selected (age cutoffs in studies varied from age ≤18 y to age ≤21 y).Data Extraction and SynthesisQuality of studies was assessed using the National Institutes of Health Quality Assessment Tools. Data on incidence, mortality, and factors associated with IHCA or mortality were extracted by 2 independent observers. Random-effects meta-analysis was used to compute pooled proportions and pooled ORs. Metaregression, adjusted for type of study and diagnostic category, was used to evaluate trends in incidence and mortality.Main Outcomes and MeasuresPrimary outcomes were incidence of IHCA and in-hospital mortality. Secondary outcomes were proportions of patients who underwent extracorporeal membrane oxygenation (ECMO) cardiopulmonary resuscitation (ECPR) and those who did not achieve return of spontaneous circulation (ROSC).ResultsOf the 2574 studies identified, 25 were included in the systematic review (131 724 patients) and 18 in the meta-analysis. Five percent (95% CI, 4%-6%) of children with cardiac disease in the ICU experienced IHCA. The pooled in-hospital mortality among children who experienced IHCA was 51% (95% CI, 42%-59%). Thirty-nine percent (95% CI, 29%-51%) did not achieve ROSC; in centers with ECMO, 22% (95% CI, 14%-33%) underwent ECPR, whereas 22% (95% CI, 12%-38%) were unable to be resuscitated. Both incidence of IHCA and associated in-hospital mortality decreased significantly in the last 20 years (both P for trend &lt; .001), whereas the proportion of patients not achieving ROSC did not significantly change (P for trend = .90). Neonatal age, prematurity, comorbidities, univentricular physiology, arrhythmias, prearrest mechanical ventilation or ECMO, and higher surgical complexity were associated with increased incidence of IHCA and mortality odds.Conclusions and RelevanceThis systematic review and meta-analysis found that 5% of children with cardiac disease in the ICU experienced IHCA. Decreasing trends in IHCA incidence and mortality suggest that education on preventive interventions, use of ECMO, and post-arrest care may have been effective; however, there remains a crucial need for developing resuscitation strategies specific to children with cardiac disease.

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Anesthetic Complications in the Neonate

Kovatsis

Kleinman

2014

Neonatal Anesthesia

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Two-year survival and neurodevelopmental outcomes after cardiopulmonary resuscitation in neonatal patients after complex cardiac surgery

Cited by 11 publications

References 21 publications

Comparison of intelligence, weight and height in children after general anesthesia with and without perioperative desaturation in non-cardiac surgery: a historical and concurrent follow-up study

Comparison of intelligence, weight and height in children after general anesthesia with and without perioperative desaturation in non-cardiac surgery: a historical and concurrent follow-up study

Trends in In-Hospital Cardiac Arrest and Mortality Among Children With Cardiac Disease in the Intensive Care Unit

Anesthetic Complications in the Neonate

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