ABSTRACT 12

Abstract

Background and aims: Hypothermia (HT) as neuroprotector, has evidence in animals, newborns and adults but not in pediatrics. Aims: Compare effectiveness and safety of two methods of mild hypothermia: servo controlled system (SCS) and physical measures (PM) in pediatric cardiac arrest (CA). Methods: Children admitted to PICUs with CA from June 2012 to June 2014, from 50 hospitals in 7 different countries. In-hospital (IH) or out of hospital (OH) CA, more than 2’ CPR, coma and mechanical ventilation at ROSC, are included. Patients with severe neurological damage, DNR, limitation of therapeutic effort or hypothermia started after 6 hours post ROSC are excluded. Online recorded data, informed consent and ethical committee approval were obtained. Intervention: mild hypothermia 32–34°C for 48 hours; slow return to normothermia. Results: 65 patients, 63% OH, 37% IH, 74% SCS, 26% PM. Demographic data, severity and HT induction (3h) similar in both groups; maintenance HT, 33,2°C SCS, 33,5°C PM; temperature outside target range greater in PM (p<0,02). Most frequent complications: hyperglycemia (p=0,88), prolonged coagulation time without clinical hemorrhage (p=0,6) and seizures (p=0,8), similar in both groups. Survival 63% SCS and 56% PM (p=0,6); PCPC score 1 and 2, 59% SCS and 44% PM, (p=0,28). Hospitalization days 9 SCS, 17 PM (p= 0,16). PICU days 8 SCS and 13 PM (p= 0,21). MV days: 6 SCS and 11 PM (p= 0,31). Conclusions: SCS is better in keeping temperature stability. There is a trend for shorter Hospitalization, PICU and MV days; No significant differences in survival and neurological outcome were found.