24 vs. 72 hours of hypothermia for pediatric cardiac arrest: A pilot, randomized controlled trial.
Resuscitation
; 126: 14-20, 2018 05.
Article
en En
| MEDLINE
| ID: mdl-29454009
ABSTRACT
AIM:
Children surviving cardiac arrest (CA) lack proven neuroprotective therapies. The role of biomarkers in assessing response to interventions is unknown. We hypothesized that 72 versus 24â¯h of hypothermia (HT) would produce more favorable biomarker profiles after pediatric CA.METHODS:
This single center pilot randomized trial tested HT (33⯱â¯1⯰C) for 24 vs. 72â¯h in 34 children with CA. Children comatose after return of circulation aged 1 week to 17 years and treated with HT by their physician were eligible. Serum was collected twice daily on days 1-4 and once on day 7. Mortality was assessed at 6 months.RESULTS:
Patient characteristics, baseline biomarker concentrations, and adverse events were similar between groups. Eight (47%) and 4 (24%) children died in the 24â¯h and 72â¯h groups, pâ¯=â¯.3. Serum neuron specific enolase (NSE) concentration was increased in the 24 vs. 72â¯h group at 84â¯h-96â¯h (median [interquartile range] 47.7 [3.9, 79.9] vs. 1.4 [0.0, 11.1] ng/ml, pâ¯=â¯.02) and on day 7 (18.2 [3.2, 74.0] vs. 2.6 [0.0, 12.8] ng/ml, pâ¯=â¯.047). Serum S100b was increased in the 24â¯h vs. 72â¯h group at 12â¯h-24â¯h, 36â¯h-84â¯h, and on day 7, all pâ¯<â¯0.05. HT duration was associated with S100b (but not NSE or MBP) concentration on day 7 in multivariate analyses.CONCLUSION:
Serum biomarkers show promise as theragnostic tools in pediatric CA. Our biomarker and safety data also suggest that 72â¯h duration after pediatric CA warrants additional exploration.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de salud:
1_doencas_nao_transmissiveis
/
2_muertes_prematuras_enfermedades_notrasmisibles
/
2_muertes_prevenibles
/
6_cardiovascular_diseases
/
7_neonatal_care_health
/
7_non_communicable_diseases
Asunto principal:
Paro Cardíaco Extrahospitalario
/
Hipotermia Inducida
Tipo de estudio:
Clinical_trials
/
Prognostic_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Idioma:
En
Revista:
Resuscitation
Año:
2018
Tipo del documento:
Article