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Randomized Controlled Trial
. 2018 Jun:127:44-50.
doi: 10.1016/j.resuscitation.2018.03.034. Epub 2018 Mar 27.

Burden of caregiving after a child's in-hospital cardiac arrest

Kathleen Meert  1 , Beth S Slomine  2 , James R Christensen  2 , Russell Telford  3 , Richard Holubkov  3 , J Michael Dean  3 , Frank W Moler  4
Affiliations
Randomized Controlled Trial

Burden of caregiving after a child's in-hospital cardiac arrest

Kathleen Meert et al. Resuscitation. 2018 Jun.

Abstract

Objective: To describe caregiver burden among those whose children survive in-hospital cardiac arrest and have high risk of neurologic disability, and explore factors associated with burden during the first year post-arrest.

Methods: The study is a secondary analysis of the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial. 329 children who had an in-hospital cardiac arrest, chest compressions for >2 min, and mechanical ventilation after return of circulation were recruited to THAPCA-IH. Of these, 155 survived to one year, and caregivers of 138 were assessed for burden. Caregiver burden was assessed at baseline, and 3 and 12 months post-arrest using the Infant Toddler Quality of Life Questionnaire for children <5 years old and the Child Health Questionnaire for children >5 years. Child functioning was assessed using the Vineland Adaptive Behaviour Scales Second Edition (VABS-II), the Paediatric Overall Performance Category (POPC) and Paediatric Cerebral Performance Category (PCPC) scales, and caregiver perception of global functioning.

Results: Of 138 children, 77 (55.8%) were male, 77 (55.8%) were white, and 109 (79.0%) were <5 years old at the time of arrest. Caregiver burden was greater than reference norms at all time points. Worse POPC, PCPC and VABS-II scores at 3 months post-arrest were associated with greater caregiver burden at 12 months. Worse global functioning at 3 months was associated with greater burden at 12 months for children <5 years.

Conclusions: Caregiver burden is substantial during the first year after paediatric in-hospital cardiac arrest, and associated with the extent of the child's neurobehavioural dysfunction.

Keywords: Caregiving; In-hospital cardiac arrest; Neurobehavioural outcome; Paediatric.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Primary support for the conduct of the THAPCA-IH Trial was funding from the National Institutes of Health (NIH), National Heart, Lung, and Blood Institute, Bethesda, MD. HL094345 (FWM) and HL094339 (JMD). Additional support from the following federal planning grants contributed to the planning of the THAPCA Trials: NIH, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), Bethesda, MD. HD044955 (FWM) and HD050531 (FWM). In part support was obtained from the participation of the following research networks: Paediatric Emergency Care Applied Research Network (PECARN) from cooperative agreements U03MC00001, U03MC00003, U03MC00006, U03MC00007, and U03MC00008; and the Collaborative Paediatric Critical Care Research Network (CPCCRN) from cooperative agreements (U10HD500009, U10HD050096, U10HD049981, U10HD049945, U10HD049983, U10HD050012 and U01HD049934. At several centres (as indicated below), clinical research support was supplemented by the following grants or Cooperative Agreements: UL1 RR 024986, UL1 TR 000433, U54 HD087011, UL1TR000003, and P30HD040677. The National Emergency Medical Services for Children (EMSC) Data Analysis Resource Centre Demonstration grant U07MC09174 provided for educational study materials.

Figures

Figure 1
Figure 1. Caregiver Burden 12 Months after a Child’s In-Hospital Cardiac Arrest
Percent of caregivers reporting normal/mild, moderate, and high levels of burden for each assessed caregiver burden domain12 months after their child’s cardiac arrest. Abbreviations: ITQOL, Infant Toddler Quality of Life; CHQ, Child Health Questionnaire.
See this image and copyright information in PMC

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