Kim Da Hyun, Yum Mi-Sun, Jhang Won Kyoung, Kim Min-Jee
Division of Pediatric Emergency Medicine, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Division of Pediatric Neurology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
Sci Rep. 2025 Aug 27;15(1):31606. doi: 10.1038/s41598-025-15152-z.
This study aimed to identify neurologic prognostic factors after cardiac arrest in pediatric patients, focusing on clinical features and electroencephalography (EEG) findings. This is a retrospective single-center study. We analyzed resuscitated pediatric patients who admitted pediatric intensive care unit at a tertiary academic referral hospital in South Korea. Patients aged 1 month to 18 years with in-hospital cardiac arrest between January 2010 and October 2022 who received EEG within 7 days were included. The primary outcome was a favorable neurologic outcome, defined as a Pediatric Cerebral Performance Category score of 1-2, assessed at 6 months post-cardiac arrest. Sixty-two pediatric patients were included, with 16 (25.8%) achieving favorable outcomes. Multivariate logistic regression analyses identified initial shockable rhythm (p = 0.032), normal background voltage (p = 0.026), and continuous or nearly continuous background activity (p = 0.017) on standardized EEG as significant predictors of favorable neurologic outcomes at 6 months. The combination of an initial shockable rhythm with normal voltage or continuous EEG background enhanced prognostic accuracy (specificity = 100%). This study suggests that specific EEG background patterns-alpha frequency, normal voltage, and continuous or nearly continuous activity-within 1 week post-return of spontaneous circulation serve as indicators of favorable 6-month neurologic outcomes.
本研究旨在确定小儿心脏骤停后的神经预后因素，重点关注临床特征和脑电图（EEG）结果。这是一项回顾性单中心研究。我们分析了在韩国一家三级学术转诊医院儿科重症监护病房收治的复苏小儿患者。纳入2010年1月至2022年10月期间在院内发生心脏骤停且在7天内接受脑电图检查的1个月至18岁患者。主要结局是良好的神经学结局，定义为心脏骤停后6个月时小儿脑功能分类评分为1 - 2分。纳入了62例小儿患者，其中16例（25.8%）获得良好结局。多因素逻辑回归分析确定，标准化脑电图上的初始可电击心律（p = 0.032）、正常背景电压（p = 0.026）以及持续或近乎持续的背景活动（p = 0.017）是6个月时良好神经学结局的重要预测因素。初始可电击心律与正常电压或持续脑电图背景相结合可提高预后准确性（特异性 = 100%）。本研究表明，自主循环恢复后1周内特定的脑电图背景模式——α频率、正常电压以及持续或近乎持续的活动——可作为6个月时良好神经学结局的指标。
