Children's Hospital of Michigan, Wayne State University, 3901 Beaubien Boulevard, Detroit, MI 48201, USA.
Kennedy Krieger Institute, Johns Hopkins University, 707 North Broadway, Baltimore, MD 21205, USA.
Resuscitation. 2018 Jun;127:44-50. doi: 10.1016/j.resuscitation.2018.03.034. Epub 2018 Mar 27.
To describe caregiver burden among those whose children survive in-hospital cardiac arrest and have high risk of neurologic disability, and explore factors associated with burden during the first year post-arrest.
The study is a secondary analysis of the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial. 329 children who had an in-hospital cardiac arrest, chest compressions for >2 min, and mechanical ventilation after return of circulation were recruited to THAPCA-IH. Of these, 155 survived to one year, and caregivers of 138 were assessed for burden. Caregiver burden was assessed at baseline, and 3 and 12 months post-arrest using the Infant Toddler Quality of Life Questionnaire for children <5 years old and the Child Health Questionnaire for children >5 years. Child functioning was assessed using the Vineland Adaptive Behaviour Scales Second Edition (VABS-II), the Paediatric Overall Performance Category (POPC) and Paediatric Cerebral Performance Category (PCPC) scales, and caregiver perception of global functioning.
Of 138 children, 77 (55.8%) were male, 77 (55.8%) were white, and 109 (79.0%) were <5 years old at the time of arrest. Caregiver burden was greater than reference norms at all time points. Worse POPC, PCPC and VABS-II scores at 3 months post-arrest were associated with greater caregiver burden at 12 months. Worse global functioning at 3 months was associated with greater burden at 12 months for children <5 years.
Caregiver burden is substantial during the first year after paediatric in-hospital cardiac arrest, and associated with the extent of the child's neurobehavioural dysfunction.
描述存活于院内心脏骤停且有高神经功能残疾风险患儿的照护者负担，并探讨复苏后 1 年内与负担相关的因素。
该研究为儿科心脏骤停院内治疗性低温（THAPCA-IH）试验的二次分析。共招募了 329 名经历院内心脏骤停、按压>2 min 且循环恢复后接受机械通气的患儿。其中 155 名患儿存活至 1 年，对 138 名患儿的照护者进行了负担评估。使用婴儿-学步儿生活质量问卷（适用于<5 岁儿童）和儿童健康问卷（适用于>5 岁儿童），分别在基线时、复苏后 3 个月和 12 个月评估照护者负担。使用 Vineland 适应行为量表第二版（VABS-II）、儿科总体表现类别（POPC）和儿科脑功能表现类别（PCPC）量表评估儿童的功能，并通过照护者感知的整体功能来评估。
在 138 名儿童中，77 名（55.8%）为男性，77 名（55.8%）为白人，109 名（79.0%）患儿在发生心脏骤停时<5 岁。在所有时间点，照护者负担均大于参考值。复苏后 3 个月时 POPC、PCPC 和 VABS-II 评分较差与 12 个月时照护者负担较重相关。3 个月时整体功能较差与<5 岁患儿 12 个月时负担较重相关。
在儿科院内心脏骤停后 1 年内，照护者负担较大，与患儿神经行为功能障碍的严重程度相关。
