Evidence map›Paper›PMID 38866233›Full record

Trial reportResuscitation2024

Association of EEG characteristics with outcomes following pediatric ICU cardiac arrest: A secondary analysis of the ICU-RESUScitation trial.

Emma L Mazzio, Alexis A Topjian, Ron W Reeder, Robert M Sutton, Ryan W Morgan, Robert A Berg, Vinay M Nadkarni, Heather A Wolfe, Kathryn Graham, Maryam Y Naim and 5 more

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

Trial report in Resuscitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Emma L MazzioDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA. Electronic address: mazzioe@chop.edu.
Alexis A TopjianDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Ron W ReederDepartment of Pediatrics, University of Utah, Salt Lake City, UT, USA.
Robert M SuttonDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Ryan W MorganDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Robert A BergDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Vinay M NadkarniDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Heather A WolfeDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Kathryn GrahamDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Maryam Y NaimDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Stuart H FriessDepartment of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Nicholas S AbendDepartments of Neurology and Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Craig A PressDepartments of Neurology and Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
ICU-RESUS Eunice Kennedy Shriver National Institute of Child Health
Human Development Collaborative Pediatric Critical Care Research Network Investigator Groups

Funding

Data Coordinating Center for the Collaborative Pediatric Critical Care Research NetworkU01HD049934 · NICHD · UNIVERSITY OF UTAH · PI DEAN, JONATHAN MICHAEL · 2005 to 2020
$35.2M
CPCCRN PRECISE SupplementPL1HD105462 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Jonathan Michael Dean · 2021 to 2026
$17.5M
Improving Outcomes after Pediatric Cardiac ArrestR01HL131544 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI SUTTON, ROBERT MICHAEL · 2016 to 2020
$3.9M
Collaborative Pediatric Critical Care Research Network (CPCCRN) at Children's NationalUG1HD049981 · NICHD · CHILDREN'S RESEARCH INSTITUTE · PI POLLACK, MURRAY MICHAEL, WESSEL, DAVID LLOYD · 2015 to 2020
$1.8M
Pediatric Critical Care Research Network at Children's Hospital of PhiladelphiaUG1HD063108 · NICHD · CHILDREN'S HOSP OF PHILADELPHIA · PI BERG, ROBERT ALLEN, ZUPPA, ATHENA F. · 2015 to 2020
$1.7M
Collaborative Research to Validate Biomarkers of Pediatric ARDSUG1HD083166 · NICHD · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MCQUILLEN, PATRICK SEAN, SAPRU, ANIL · 2015 to 2020
$1.6M
Renewal Application for the Childrens Hospital of Pittsburgh Collaborative Pediatric Critical Care Research Network SiteUG1HD049983 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CARCILLO, JOSEPH A · 2015 to 2020
$1.6M
Collaborative Pediatric Critical Care Research NetworkUG1HD050096 · NICHD · WAYNE STATE UNIVERSITY · PI MEERT, KATHLEEN L. · 2015 to 2020
$1.6M
Collaborative Network Study of Airway Microbiome and Host Responses in Pediatric Respiratory FailureUG1HD083171 · NICHD · UNIVERSITY OF COLORADO DENVER · PI CARPENTER, TODD C · 2015 to 2020
$1.5M
Collaborative Pediatric Critical Care Research Network (UG1)UG1HD083170 · NICHD · RESEARCH INST NATIONWIDE CHILDREN'S HOSP · PI HALL, MARK W · 2015 to 2020
$1.5M
Validation of Physiologic CPR Quality Using NOn-inVasive Waveform Analytics (CPR-NOVA)R01HL147616 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI BERG, ROBERT ALLEN, SUTTON, ROBERT MICHAEL · 2019 to 2021
$1.2M
The Roles of Pulmonary Hypertension and Right Ventricular Dysfunction in Pediatric Acute Respiratory Distress SyndromeK23HL153759 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI HIMEBAUCH, ADAM S. · 2021 to 2025
$879k
NHLBI NIH HHS K23 HL148541NHLBI NIH HHS K23 HL153759NHLBI NIH HHS R01 HL131544NHLBI NIH HHS R01 HL147616NICHD NIH HHS PL1 HD105462NICHD NIH HHS RL1 HD107773NICHD NIH HHS U01 HD049934NICHD NIH HHS UG1 HD049981NICHD NIH HHS UG1 HD049983NICHD NIH HHS UG1 HD050096NICHD NIH HHS UG1 HD063108NICHD NIH HHS UG1 HD083166NICHD NIH HHS UG1 HD083170NICHD NIH HHS UG1 HD083171
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThere are limited tools available following cardiac arrest to prognosticate neurologic outcomes. Prior retrospective and single center studies have demonstrated early EEG features are associated with neurologic outcome. This study aimed to evaluate the prognostic value of EEG for pediatric in-hospital cardiac arrest (IHCA) in a prospective, multicenter study.

methodsThis cohort study is a secondary analysis of the ICU-Resuscitation trial, a multicenter randomized interventional trial conducted at 18 pediatric and pediatric cardiac ICUs in the United States. Patients who achieved return of circulation (ROC) and had post-ROC EEG monitoring were eligible for inclusion. Patients < 90 days old and those with pre-arrest Pediatric Cerebral Performance Category (PCPC) scores > 3 were excluded. EEG features of interest included EEG Background Category, and presence of focal abnormalities, sleep spindles, variability, reactivity, periodic and rhythmic patterns, and seizures. The primary outcome was survival to hospital discharge with favorable neurologic outcome. Associations between EEG features and outcomes were assessed with multivariable logistic regression. Prediction models with and without EEG Background Category were developed and receiver operator characteristic curves compared.

resultsOf the 1129 patients with an index cardiac arrest who achieved ROC in the parent study, 261 had EEG within 24 h of ROC, of which 151 were evaluable. The cohort included 57% males with a median age of 1.1 years (IQR 0.4, 6.8). EEG features including EEG Background Category, sleep spindles, variability, and reactivity were associated with survival with favorable outcome and survival, (all p < 0.001). The addition of EEG Background Category to clinical models including age category, illness category, PRISM score, duration of CPR, first documented rhythm, highest early post-arrest arterial lactate improved the prediction accuracy achieving an AUROC of 0.84 (CI 0.77-0.92), compared to AUROC of 0.76 (CI 0.67-0.85) (p = 0.005) without EEG Background Category.

conclusionThis multicenter study demonstrates the value of EEG, in the first 24 h following ROC, for predicting survival with favorable outcome after a pediatric IHCA.

Indexed as

Cardiopulmonary ResuscitationElectroencephalographyHeart ArrestChildChild, PreschoolFemaleHumansInfantIntensive Care Units, PediatricMalePrognosisProspective StudiesCardiac arrestElectroencephalographyNeuro-prognosticationPediatric cardiac arrestPost-resuscitation care

Identifiers

PMID38866233
PMCPMC11331055

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Registered trials

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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.