Practice patterns for acquiring neuroimaging after pediatric in-hospital cardiac arrest.
Publication/Presentation Date
2-1-2025
Abstract
AIMS: To determine which patient and cardiac arrest factors were associated with obtaining neuroimaging after in-hospital cardiac arrest, and among those patients who had neuroimaging, factors associated with which neuroimaging modality was obtained.
METHODS: Retrospective cohort study of patients who survived in-hospital cardiac arrest (IHCA) and were enrolled in the ICU-RESUS trial (NCT02837497).
RESULTS: We tabulated ultrasound (US), CT, and MRI frequency within 7 days following IHCA and identified patient and cardiac arrest factors associated with neuroimaging modalities utilized. Multivariable models determined which factors were associated with obtaining neuroimaging. Of 1000 patients, 44% had ≥ 1 neuroimaging study (US in 31%, CT in 18%, and MRI in 6% of patients). Initial USs were performed a median of 0.3 [0.1,0.5], CTs 1.4 [0.4,2.8], and MRIs 4.1 [2.2,5.1] days post-arrest. Neuroimaging timing and frequency varied by site. Factors associated with greater odds of neuroimaging were cardiac arrest in CICU (versus PICU), longer duration CPR, receiving ECMO post-arrest, and post-arrest care with targeted temperature management or EEG monitoring. US performance was associated with congenital heart disease. CT was associated with age ≥ 1-month, greater pre-arrest disability, and receiving CPR for ≥ 16 min. MRI utilization increased with pre-existing respiratory insufficiency and respiratory decompensation as arrest cause, and medical cardiac and surgical non-cardiac or trauma illness category. Overall, if neuroimaging was obtained, US was more common in CICU while CT/MRI were utilized more in PICU.
CONCLUSIONS: Practice patterns for acquiring neuroimaging after IHCA are variable and influenced by patient, cardiac arrest, and site factors.
Volume
207
First Page
110506
Last Page
110506
ISSN
1873-1570
Published In/Presented At
Kirschen, M. P., Ullman, N. L., Reeder, R. W., Ahmed, T., Bell, M. J., Berg, R. A., Burns, C., Carcillo, J. A., Carpenter, T. C., Wesley Diddle, J., Federman, M., Fink, E. L., Frazier, A. H., Friess, S. H., Graham, K., Horvat, C. M., Huard, L. L., Kilbaugh, T. J., Maa, T., Manga, A., … Press, C. A. (2025). Practice patterns for acquiring neuroimaging after pediatric in-hospital cardiac arrest. Resuscitation, 207, 110506. https://doi.org/10.1016/j.resuscitation.2025.110506
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
39848427
Department(s)
Department of Pediatrics
Document Type
Article