NEUROlogical Prognosis After Cardiac Arrest in Kids (NEUROPACK) study: protocol for a prospective multicentre clinical prediction model derivation and validation study in children after cardiac arrest
Elizabeth S Draper,
John Pappachan,
Kent Thorburn,
David Inwald,
Richard Feltbower,
Buvana Dwarakanathan,
Patrick Davies,
Kate Penny-Thomas,
Rum Thomas,
Kevin P Morris,
Roger Parslow,
Timothy Thiruchelvam,
Sophie Skellett,
Hari Krishnan Kanthimathinathan,
Victoria Hiley,
Peter Barry,
Sian Cooper,
Rohit Saxena,
Cormac Breatnach,
Barnaby Robert Scholefield,
Sarah Evans,
Mirjam Kool,
Alice J Sitch,
Fang Smith,
Yamuna Thiru,
Richard Levin,
Rachel Agbecko,
James Weitz,
Akash Deep,
Sandra Gala-Peralta,
Milly Lo,
Rachael Barber,
Stewart Reid,
Siva Oruganti,
Kalai Sadasivam,
Mark Bebbington
Affiliations
Elizabeth S Draper
Health Sciences, University of Leicester, Leicester, UK
John Pappachan
9 Paediatric Intensive Care, Southampton Children’s Hospital, Southampton, UK
Kent Thorburn
10 Paediatric Intensive Care, Royal Liverpool Childrens Hospital Alder Hey, Liverpool, UK
David Inwald
12 Paediatric Intensive Care Unit, Imperial College Healthcare NHS Trust, London, UK
Richard Feltbower
5 School of Medicine, University of Leeds, Leeds, UK
Buvana Dwarakanathan
1St George’s Hospial, London, UK
Patrick Davies
3 Department of Paediatric Critical Care, Nottingham University Hospitals NHS Trust, Nottingham, UK
Kate Penny-Thomas
Paediatric Intensive Care Unit, Birmingham Women and Children's NHS Foundation Trust, Birmingham, West Midlands, UK
Rum Thomas
2 Paediatric Intensive Care Unit, Sheffield Children's Hospital, Sheffield, UK
Kevin P Morris
6 Paediatric Intensive Care Unit, Birmingham Women’s and Children’s Hospitals NHS Foundation Trust, Birmingham, UK
Roger Parslow
School of Medicine, University of Leeds, Leeds, UK
Timothy Thiruchelvam
3 Cardiac Intensive Care, Great Ormond Street Hospital, London, UK
Sophie Skellett
GOSH
Hari Krishnan Kanthimathinathan
Birmingham Acute Care Research Group, University of Birmingham College of Medical and Dental Sciences, Birmingham, West Midlands, UK
Victoria Hiley
Leeds Institute for Data Analytics, University of Leeds, Leeds, West Yorkshire, UK
Peter Barry
2North West Lung Centre, University Hospital of South Manchester, Manchester, UK
Sian Cooper
1 Paediatric Intensive Care Unit, Leeds Teaching Hospitals NHS Trust, Leeds, UK
Rohit Saxena
Dr RP Centre, All India Institute for Medical Science, New Delhi, Delhi, India
Cormac Breatnach
Paediatric Intensive Care Unit, Our Lady’s Children’s Hospital, Dublin, Ireland
Barnaby Robert Scholefield
Birmingham Acute Care Research Group, University of Birmingham College of Medical and Dental Sciences, Birmingham, West Midlands, UK
Sarah Evans
Paediatric Intensive Care Unit, Birmingham Women and Children's NHS Foundation Trust, Birmingham, West Midlands, UK
Mirjam Kool
Birmingham Acute Care Research Group, University of Birmingham College of Medical and Dental Sciences, Birmingham, West Midlands, UK
Alice J Sitch
Institute of Applied Health Research, University of Birmingham, Birmingham, UK
Fang Smith
Birmingham Acute Care Research Group, University of Birmingham College of Medical and Dental Sciences, Birmingham, West Midlands, UK
Yamuna Thiru
Richard Levin
4Royal Hospital for Sick Children, NHS Greater Glasgow and Clyde, Glasgow, UK
Rachel Agbecko
James Weitz
Akash Deep
Paediatric Intensive Care Unit, King's College Hospital NHS Foundation Trust, London, UK
Introduction Currently, we are unable to accurately predict mortality or neurological morbidity following resuscitation after paediatric out of hospital (OHCA) or in-hospital (IHCA) cardiac arrest. A clinical prediction model may improve communication with parents and families and risk stratification of patients for appropriate postcardiac arrest care. This study aims to the derive and validate a clinical prediction model to predict, within 1 hour of admission to the paediatric intensive care unit (PICU), neurodevelopmental outcome at 3 months after paediatric cardiac arrest.Methods and analysis A prospective study of children (age: >24 hours and <16 years), admitted to 1 of the 24 participating PICUs in the UK and Ireland, following an OHCA or IHCA. Patients are included if requiring more than 1 min of cardiopulmonary resuscitation and mechanical ventilation at PICU admission Children who had cardiac arrests in PICU or neonatal intensive care unit will be excluded. Candidate variables will be identified from data submitted to the Paediatric Intensive Care Audit Network registry. Primary outcome is neurodevelopmental status, assessed at 3 months by telephone interview using the Vineland Adaptive Behavioural Score II questionnaire. A clinical prediction model will be derived using logistic regression with model performance and accuracy assessment. External validation will be performed using the Therapeutic Hypothermia After Paediatric Cardiac Arrest trial dataset. We aim to identify 370 patients, with successful consent and follow-up of 150 patients. Patient inclusion started 1 January 2018 and inclusion will continue over 18 months.Ethics and dissemination Ethical review of this protocol was completed by 27 September 2017 at the Wales Research Ethics Committee 5, 17/WA/0306. The results of this study will be published in peer-reviewed journals and presented in conferences.Trial registration number NCT03574025.
