PDF(Pubmed)
Abstract：
UNASSIGNED: Investigate long-term outcome in paediatric submersion-related cardiac arrests (CA).
UNASSIGNED: Children (age one day-17 years) were included if admitted to the Erasmus MC Sophia Children\'s Hospital, after drowning with CA, between 2002 and 2019. Primary outcome was survival with favourable neurological outcome, defined as a Paediatric Cerebral Performance Category (PCPC) score of 1-3 at longest available follow-up. Secondary outcome were age-appropriate neuropsychological assessments at longest available follow-up.
UNASSIGNED: Upon hospital admission, 99 children were included (median age at time of CA 3.2 years [IQR 2.0-5.9] and 65% males). Forty children died in-hospital (no return of circulation (45%) or withdrawal of life sustaining therapies (55%)) and 4 children deceased after hospital discharge due to complications following the drowning-incident. Among survivors, with a median follow-up of 2.3 years [IQR 0.2-5.5], 47 children had favourable neurological outcome (i.e. PCPC 1-3) and 8 children unfavourable (unfavourable outcome group total n = 52, i.e. PCPC 4-5 or deceased). Twenty-six (47%) children participated in a neuropsychological assessment (median follow-up 4.0 years [IQR 2.3-8.7]). Compared with normative test data, participants obtained worse general (p = 0.008) and performance (p = 0.003) intelligence scores, processing speed (p = 0.002) and visual motor integration scores (p = 0.0012).
UNASSIGNED: Although overall outcome in survivors was favourable at longest available follow-up, significant deficits in neuropsychological assessments were found. This study underlines the need for a standardized long term follow-up program as standard of care in paediatric drowning with CA.
UNASSIGNED: Children (age one day-17 years) were included if admitted to the Erasmus MC Sophia Children\'s Hospital, after drowning with CA, between 2002 and 2019. Primary outcome was survival with favourable neurological outcome, defined as a Paediatric Cerebral Performance Category (PCPC) score of 1-3 at longest available follow-up. Secondary outcome were age-appropriate neuropsychological assessments at longest available follow-up.
UNASSIGNED: Upon hospital admission, 99 children were included (median age at time of CA 3.2 years [IQR 2.0-5.9] and 65% males). Forty children died in-hospital (no return of circulation (45%) or withdrawal of life sustaining therapies (55%)) and 4 children deceased after hospital discharge due to complications following the drowning-incident. Among survivors, with a median follow-up of 2.3 years [IQR 0.2-5.5], 47 children had favourable neurological outcome (i.e. PCPC 1-3) and 8 children unfavourable (unfavourable outcome group total n = 52, i.e. PCPC 4-5 or deceased). Twenty-six (47%) children participated in a neuropsychological assessment (median follow-up 4.0 years [IQR 2.3-8.7]). Compared with normative test data, participants obtained worse general (p = 0.008) and performance (p = 0.003) intelligence scores, processing speed (p = 0.002) and visual motor integration scores (p = 0.0012).
UNASSIGNED: Although overall outcome in survivors was favourable at longest available follow-up, significant deficits in neuropsychological assessments were found. This study underlines the need for a standardized long term follow-up program as standard of care in paediatric drowning with CA.
摘要：
■调查儿科浸没相关心脏骤停（CA）的长期结果。
■如果入住伊拉斯谟MC索菲亚儿童医院，则包括儿童（1天至17岁），被CA淹死后,2002年至2019年。主要结果是生存和良好的神经系统结局，定义为在最长的可用随访中，儿科脑功能分类（PCPC）评分为1-3分。次要结果是在最长的可用随访中进行适合年龄的神经心理学评估。
■入院后，包括99名儿童（CA时的中位年龄为3.2岁[IQR2.0-5.9]，男性为65％）。40名儿童在医院死亡（未恢复血液循环（45％）或停止维持生命的治疗（55％）），4名儿童因溺水事件后的并发症而出院后死亡。在幸存者中，中位随访时间为2.3年[IQR0.2-5.5]，47名儿童具有良好的神经系统结局（即PCPCP1-3），8名儿童不利（不利结局组总计n=52，即PCP4-5或死亡）。26名（47％）儿童参加了神经心理学评估（中位随访4.0年[IQR2.3-8.7]）。与规范试验数据比较,参与者获得了较差的一般(p=0.008)和表现(p=0.003)智力得分，处理速度(p=0.002)和视觉运动积分(p=0.0012)。
■尽管在最长的随访中，幸存者的总体结局是有利的，发现神经心理学评估存在显著缺陷.这项研究强调了需要标准化的长期随访计划作为CA儿科溺水的护理标准。
■如果入住伊拉斯谟MC索菲亚儿童医院，则包括儿童（1天至17岁），被CA淹死后,2002年至2019年。主要结果是生存和良好的神经系统结局，定义为在最长的可用随访中，儿科脑功能分类（PCPC）评分为1-3分。次要结果是在最长的可用随访中进行适合年龄的神经心理学评估。
■入院后，包括99名儿童（CA时的中位年龄为3.2岁[IQR2.0-5.9]，男性为65％）。40名儿童在医院死亡（未恢复血液循环（45％）或停止维持生命的治疗（55％）），4名儿童因溺水事件后的并发症而出院后死亡。在幸存者中，中位随访时间为2.3年[IQR0.2-5.5]，47名儿童具有良好的神经系统结局（即PCPCP1-3），8名儿童不利（不利结局组总计n=52，即PCP4-5或死亡）。26名（47％）儿童参加了神经心理学评估（中位随访4.0年[IQR2.3-8.7]）。与规范试验数据比较,参与者获得了较差的一般(p=0.008)和表现(p=0.003)智力得分，处理速度(p=0.002)和视觉运动积分(p=0.0012)。
■尽管在最长的随访中，幸存者的总体结局是有利的，发现神经心理学评估存在显著缺陷.这项研究强调了需要标准化的长期随访计划作为CA儿科溺水的护理标准。
