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Published on: February 11, 2017
Cardiac arrest in infants, children, and adolescents: long-term emotional and behavioral functioning
Lennart van Zellem1, Elisabeth M Utens2, Marlous Madderom1,2
1Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Wytemaweg 80, 3015 CN, Rotterdam, The Netherlands.
Insights
Children surviving cardiac arrest (CA) often experience long-term attention and somatic problems. These issues can impact school performance, highlighting the need for ongoing monitoring and support.
Area of Science:
- Pediatric critical care medicine
- Child psychology
- Neuroscience
Background:
- Critical illness significantly impacts long-term emotional and behavioral health in children.
- Previous studies identified issues in survivors of congenital heart disease, meningococcal septic shock, and neonatal asphyxia.
- This study is the first to investigate long-term psychological outcomes in a substantial cohort of childhood cardiac arrest survivors.
Purpose of the Study:
- To evaluate long-term emotional and behavioral functioning in children and adolescents who survived cardiac arrest (CA).
- To identify predictors associated with psychological difficulties in CA survivors.
- To provide insights for improved long-term care strategies.
Main Methods:
- A long-term follow-up study of consecutive infants, children, and adolescents surviving CA.
- Utilized validated questionnaires: Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and Youth Self-Report (YSR).
- Compared outcomes of 52 CA survivors against normative data.
Main Results:
- Parents and teachers reported significantly increased attention and somatic problems in survivors (ages 6-18).
- Parents also noted more attention problems in younger survivors (ages 1.5-5).
- Twenty-eight percent of survivors exhibited psychopathological range scores based on parent reports.
Conclusions:
- Childhood cardiac arrest survivors frequently experience long-term attention deficits and somatic complaints.
- These attention problems can negatively affect academic performance.
- Neuropsychological assessment and organized long-term follow-up are recommended for these children.
Unlabelled:
Very little is known about the psychological consequences of a cardiac arrest (CA) during childhood. Our aim was to assess long-term emotional and behavioral functioning, and its predictors, in survivors of CA in childhood. This long-term follow-up study involved all consecutive infants, children, and adolescents surviving CA in a tertiary-care university children's hospital between January 2002 and December 2011. Emotional and behavioral functioning was assessed with the Child Behavior Checklist (CBCL), Teacher's Report Form (TRF), and Youth Self-Report (YSR). Of the eligible 107 CA survivors, 52 patients, parents, and/or teachers filled out online questionnaires. Compared with normative data, parents and teachers reported significantly more attention and somatic problems (age range 6-18 years). Parents also reported more attention problems for age range 1.5-5 years. Twenty-eight percent of the children (n = 14) scored in the psychopathological range (i.e., for age range 1.5-18 years; p < 0.001) according to parent reports. Male gender, older age, and basic life support were significantly related to worse scores on the scales internalizing problems, externalizing problems, and total problems and subscale attention problems.
Conclusion:
Long-term deficits in attention and somatic complaints were reported. Attention problems after childhood CA can interfere with school performance. Long-term follow-up with neuropsychological assessment should be organized.
What Is Known:
• Critical illness has a significant influence on the presence of long-term emotional and behavioral problems. • Long-term emotional and behavioral problems have been described for various groups of critically ill children such as congenital heart disease, meningococcal septic shock, and neonatal asphyxia. What is new: • This is the first study that addresses long-term emotional and behavioral problems in a relatively large consecutive series of children and adolescents surviving cardiac arrest. • Long-term deficits in attention and somatic complaints were reported.
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