Evidence map›Paper›PMID 30807545›Full record

Trial reportPediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies2019

Cardiac Arrest Outcomes in Children With Preexisting Neurobehavioral Impairment.

James R Christensen, Beth S Slomine, Faye S Silverstein, Kent Page, Richard Holubkov, J Michael Dean, Frank W Moler, Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) Trial Investigators

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Neurocognitive functioning and health-related quality of life of children after pediatric intensive care admission: a systematic review.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022
    Pooled it
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

James R ChristensenDepartment of Pediatric Rehabilitation Medicine, Kennedy Krieger Institute, Baltimore, MD.
Beth S SlomineDepartment of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD.
Faye S SilversteinDepartment of Pediatrics, University of Michigan, Ann Arbor, MI.
Kent PageDepartment of Pediatrics, University of Utah, Salt Lake City, UT.
Richard HolubkovDepartment of Pediatrics, University of Utah, Salt Lake City, UT.
J Michael DeanDepartment of Pediatrics, University of Utah, Salt Lake City, UT.
Frank W MolerDepartment of Pediatrics, University of Michigan, Ann Arbor, MI.
Therapeutic Hypothermia after Pediatric Cardiac Arrest (THAPCA) Trial Investigators

Funding

THAPCA Trials - Scientific ApplicationU01HL094345 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MOLER, FRANK W · 2009 to 2016
$12.7M
THAPCA Trials - DCC ApplicationU01HL094339 · NHLBI · UNIVERSITY OF UTAH · PI DEAN, JONATHAN MICHAEL · 2009 to 2015
$7.4M
Hypothermia for Pediatric Cardiac Arrest Planning GrantR21HD044955 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MOLER, FRANK W · 2003 to 2004
$306k
Planning Hypothermia Trial for Pediatric Cardiac ArrestR34HD050531 · NICHD · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MOLER, FRANK W · 2006 to 2006
$189k
NHLBI NIH HHS U01 HL094339NHLBI NIH HHS U01 HL094345NICHD NIH HHS R21 HD044955NICHD NIH HHS R34 HD050531
6 · The paper itself

Abstract

objectivesTo describe survival and 3-month and 12-month neurobehavioral outcomes in children with preexisting neurobehavioral impairment enrolled in one of two parallel randomized clinical trials of targeted temperature management.

designSecondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest In-Hospital and Out-of-Hospital trials data.

settingForty-one PICUs in the United States, Canada, and United Kingdom. PATIENTS: Eighty-four participants (59 in-hospital cardiac arrest and 25 out-of-hospital cardiac arrest), 49 males, 35 females, mean age 4.6 years (SD, 5.36 yr), with precardiac arrest neurobehavioral impairment (Vineland Adaptive Behavior Scales, Second Edition composite score < 70). All required chest compressions for greater than or equal to 2 minutes, were comatose and required mechanical ventilation after return of circulation.

interventionsNeurobehavioral function was assessed using the Vineland Adaptive Behavior Scales, Second Edition at baseline (reflecting precardiac arrest status), and at 3 and 12 months postcardiac arrest, followed by on-site cognitive evaluation. Vineland Adaptive Behavior Scales, Second Edition norms are 100 (mean) ± 15 (SD); higher scores indicate better function. Analyses evaluated survival, changes in Vineland Adaptive Behavior Scales, Second Edition, and cognitive functioning. MEASUREMENTS AND MAIN

resultsTwenty-eight of 84 (33%) survived to 12 months (in-hospital cardiac arrest, 19/59 (32%); out-of-hospital cardiac arrest, 9/25 [36%]). In-hospital cardiac arrest (but not out-of-hospital cardiac arrest) survival rate was significantly lower compared with the Therapeutic Hypothermia after Pediatric Cardiac Arrest group without precardiac arrest neurobehavioral impairment. Twenty-five survived with decrease in Vineland Adaptive Behavior Scales, Second Edition less than or equal to 15 (in-hospital cardiac arrest, 18/59 (31%); out-of-hospital cardiac arrest, 7/25 [28%]). At 3-months postcardiac arrest, mean Vineland Adaptive Behavior Scales, Second Edition scores declined significantly (-5; SD, 14; p < 0.05). At 12 months, Vineland Adaptive Behavior Scales, Second Edition declined after out-of-hospital cardiac arrest (-10; SD, 12; p < 0.05), but not in-hospital cardiac arrest (0; SD, 15); 43% (12/28) had unchanged or improved scores.

conclusionsThis study demonstrates the feasibility, utility, and challenge of including this population in clinical neuroprotection trials. In children with preexisting neurobehavioral impairment, one-third survived to 12 months and their neurobehavioral outcomes varied broadly.

Indexed as

Activities of Daily LivingChildChild, PreschoolFemaleGlasgow Coma ScaleHeart ArrestHumansHypothermia, InducedInfantInfant, NewbornIntensive Care Units, PediatricInterpersonal RelationsMaleMental Status and Dementia TestsNervous System DiseasesOut-of-Hospital Cardiac Arrest

Identifiers

PMID30807545
PMCPMC6548585

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.