Survival and neurocognitive outcomes in pediatric extracorporeal-cardiopulmonary resuscitation.

Abstract:

OBJECTIVE:Extracorporeal Cardiopulmonary Resuscitation (E-CPR) is the initiation of extracorporeal life support during active chest compressions. There are no studies describing detailed neurocognitive outcomes of this population. We aim to describe the survival and neurocognitive outcomes of children who received E-CPR. METHODS:Prospective cohort study. Children who received E-CPR at the Stollery Children's Hospital between 2000 and 2010 were included. Neurocognitive follow-up, including Wechsler Preschool and Primary Scales of Intelligence, was completed at the age of 4.5 years, and at a minimum of 6 months after the E-CPR admission. RESULTS:Fifty-five patients received E-CPR between 2000 and 2010. Children with cardiac disease had a 49% survival to hospital discharge and 43% survival at age 5-years, with no survivors (n=4) in those with non-cardiac disease. Pediatric E-CPR survivors had a mean (SD) Full Scale Intelligence quotient (FSIQ) score of 76.5 (15.9); with 4 children (24%) having intellectual disability (defined as FSIQ over 2 standard deviations below the population mean; i.e., <70). Multiple Cox regression analysis found that mechanical ventilation prior to E-CPR, open chest CPR, longer duration of CPR, low pH and more red blood cells given on the first day of ECMO, and longer time for lactate to normalize on ECMO were associated with higher mortality at age 5-years. CONCLUSION:Pediatric patients with cardiac disease who required E-CPR had 43% survival at age 5 years. Of concern, the intelligence quotient in E-CPR survivors was significantly lower than the population mean, with 24% having intellectual disability.

journal_name

Resuscitation

journal_title

Resuscitation

authors

Garcia Guerra G,Zorzela L,Robertson CM,Alton GY,Joffe AR,Moez EK,Dinu IA,Ross DB,Rebeyka IM,Lequier L,Western Canadian Complex Pediatric Therapies Follow-up Group.

doi

10.1016/j.resuscitation.2015.07.034

subject

Has Abstract

pub_date

2015-11-01 00:00:00

pages

208-13

eissn

0300-9572

issn

1873-1570

pii

S0300-9572(15)00346-9

journal_volume

96

pub_type

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