| Title: |
Therapeutic Hypothermia after Out-of-Hospital Cardiac Arrest in Children |
| Authors: |
Moler, Frank W; Silverstein, Faye S; Holubkov, Richard; Slomine, Beth S; Christensen, James R; Nadkarni, Vinay M; Meert, Kathleen L; Clark, Amy E; Browning, Brittan; Pemberton, Victoria L; Page, Kent; Shankaran, Seetha; Hutchison, Jamie S; Newth, Christopher JL; Bennett, Kimberly S; Berger, John T; Topjian, Alexis; Pineda, Jose A; Koch, Joshua D; Schleien, Charles L; Dalton, Heidi J; Ofori-Amanfo, George; Goodman, Denise M; Fink, Ericka L; McQuillen, Patrick; Zimmerman, Jerry J; Thomas, Neal J; van der Jagt, Elise W; Porter, Melissa B; Meyer, Michael T; Harrison, Rick; Pham, Nga; Schwarz, Adam J; Nowak, Jeffrey E; Alten, Jeffrey; Wheeler, Derek S; Bhalala, Utpal S; Lidsky, Karen; Lloyd, Eric; Mathur, Mudit; Shah, Samir; Wu, Theodore; Theodorou, Andreas A; Sanders, Ronald C; Dean, J Michael |
| Source: |
The New England Journal of Medicine, vol 372, iss 20 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2015 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); Pediatric (rcdc); Heart Disease (rcdc); Clinical Research (rcdc); Clinical Trials and Supportive Activities (rcdc); Cardiovascular (rcdc); Cardiovascular (hrcs-hc); Adolescent (mesh); Child (mesh); Child; Preschool (mesh); Female (mesh); Humans (mesh); Hypothermia; Induced (mesh); Infant (mesh); Male (mesh); Out-of-Hospital Cardiac Arrest (mesh); Treatment Outcome (mesh); Unconsciousness (mesh); THAPCA Trial Investigators; 11 Medical and Health Sciences (for); General & Internal Medicine (science-metrix) |
| Time: |
1898 - 1908 |
| Description: |
BACKGROUND: Therapeutic hypothermia is recommended for comatose adults after witnessed out-of-hospital cardiac arrest, but data about this intervention in children are limited. METHODS: We conducted this trial of two targeted temperature interventions at 38 children's hospitals involving children who remained unconscious after out-of-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose patients who were older than 2 days and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.0°C) or therapeutic normothermia (target temperature, 36.8°C). The primary efficacy outcome, survival at 12 months after cardiac arrest with a Vineland Adaptive Behavior Scales, second edition (VABS-II), score of 70 or higher (on a scale from 20 to 160, with higher scores indicating better function), was evaluated among patients with a VABS-II score of at least 70 before cardiac arrest. RESULTS: A total of 295 patients underwent randomization. Among the 260 patients with data that could be evaluated and who had a VABS-II score of at least 70 before cardiac arrest, there was no significant difference in the primary outcome between the hypothermia group and the normothermia group (20% vs. 12%; relative likelihood, 1.54; 95% confidence interval [CI], 0.86 to 2.76; P=0.14). Among all the patients with data that could be evaluated, the change in the VABS-II score from baseline to 12 months was not significantly different (P=0.13) and 1-year survival was similar (38% in the hypothermia group vs. 29% in the normothermia group; relative likelihood, 1.29; 95% CI, 0.93 to 1.79; P=0.13). The groups had similar incidences of infection and serious arrhythmias, as well as similar use of blood products and 28-day mortality. CONCLUSIONS: In comatose children who survived out-of-hospital cardiac arrest, therapeutic hypothermia, as compared with therapeutic normothermia, did not confer a significant benefit in survival with a good functional outcome at 1 year. (Funded by the ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
qt90p6n283; https://escholarship.org/uc/item/90p6n283; https://escholarship.org/content/qt90p6n283/qt90p6n283.pdf |
| DOI: |
10.1056/nejmoa1411480 |
| Availability: |
https://escholarship.org/uc/item/90p6n283; https://escholarship.org/content/qt90p6n283/qt90p6n283.pdf; https://doi.org/10.1056/nejmoa1411480 |
| Rights: |
public |
| Accession Number: |
edsbas.610DA723 |
| Database: |
BASE |