• Resuscitation · Oct 2021

    Longitudinal two years evaluation of neuropsychological outcome in children after out of hospital cardiac arrest.

    • Maayke Hunfeld, Karolijn Dulfer, Andre Rietman, Robert Pangalila, Annabel van Gils-Frijters, Coriene Catsman-Berrevoets, Dick Tibboel, and Corinne Buysse.
    • Intensive Care and Department of Paediatric Surgery, Erasmus MC, Sophia Children's Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands; Department of Paediatric Neurology, Erasmus MC, Sophia Children's Hospital, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Electronic address: m.hunfeld@erasmusmc.nl.
    • Resuscitation. 2021 Oct 1; 167: 29-37.

    AimTo investigate longitudinal functional and neuropsychological outcomes 3-6 and 24 months after paediatric out-of-hospital cardiac arrest (OHCA). Further, to explore the association between paediatric cerebral performance category (PCPC) and intelligence.MethodsProspective longitudinal single center study including children (0-17 years) with OHCA, admitted to the PICU of a tertiary care hospital between 2012 and 2017. Survivors were assessed during an outpatient multidisciplinary follow-up program 3-6 and 24 months post-OHCA. Functional and neuropsychological outcomes were assessed through interviews, neurological exam, and validated neuropsychological testing.ResultsThe total eligible cohort consisted of 49 paediatric OHCA survivors. The most common cause of OHCA was arrhythmia (33%). Median age at time of OHCA was 48 months, 67% were males. At 3-6 and 24 months post-OHCA, respectively 74 and 73% had a good PCPC score, defined as 1-2. Compared with normative data, OHCA children obtained worse sustained attention and processing speed scores 3-6 (n = 26) and 24 (n = 27) months post-OHCA. At 24 months, they also obtained worse intelligence, selective attention and cognitive flexibility scores. In children tested at both time-points (n = 19), no significant changes in neuropsychological outcomes were found over time. Intelligence scores did not correlate with PCPC.ConclusionAlthough paediatric OHCA survivors had a good PCPC score 3-6 and 24 months post-OHCA, they obtained worse scores on important neuropsychological domains such as intelligence and executive functioning (attention and cognitive flexibility). Follow-up should continue over a longer life span in order to fully understand the long-term impact of OHCA in childhood.Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

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