title: Two-year survival and neurodevelopmental outcomes after cardiopulmonary resuscitation in neonatal patients after complex cardiac surgery.
abstract: OBJECTIVE
  To examine survival and neurodevelopmental outcomes in neonates having post-operative cardiopulmonary resuscitation (CPR).
  
  
  METHODS
  This inception cohort study included all neonates (6 weeks old or less) who received postoperative CPR (Group 1) after cardiac surgery from 1996 to 2005, matched for heart defect, year of surgery, chromosomal abnormality, and socioeconomic status to two neonates who did not receive postoperative CPR (Group 2). Two-year neurodevelopment was prospectively assessed with Bayley Scales of Infant Development II and Adaptive Behavior Assessment System II. Pre-, intra-, and post-operative variables were collected prospectively. Cardiac arrest variables were collected retrospectively. Predictors of mortality were analyzed by univariate analysis and conditional multiple logistic regression.
  
  
  RESULTS
  There were 29 patients in Group 1, and 58 patients in Group 2. In survivors, there were no significant differences between Groups 1 and 2 in outcomes [mean (SD)] of mental developmental index [84.5 (12.2) vs. 81.0 (18.9)], psychomotor developmental index [82.8 (13.8) vs. 80.1 (21.9)], General Adaptive Composite [84.6 (15.3) vs. 84.3 (19.2)], Motor scale [8.4 (3.2) vs. 8.0 (3.8)], or delay on any of these scales. Two-year mortality [58.6% Group 1; 8.6% Group 2], was associated on conditional multiple logistic regression with CPR (OR 26.6; 95% CI, 5.4, 129.5). In Group 1, on multiple logistic regression, 2-year mortality was associated with minutes of chest compressions (OR 1.04, 95% CI, 1.01, 1.08).
  
  
  CONCLUSIONS
  Among neonates having cardiac surgery, CPR is associated with greater mortality. There is no evidence that CPR survivors have different 2-year neurodevelopmental outcomes than those neonates not having CPR.
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Gregory
authors.initials: G
authors.lastname: Hansen
authors.forename: Ari R
authors.initials: AR
authors.lastname: Joffe
authors.forename: Alberto
authors.initials: A
authors.lastname: Nettel-Aguirre
authors.forename: Charlene M T
authors.initials: CM
authors.lastname: Robertson
authors.forename: Wayne S G
authors.initials: WS
authors.lastname: Biggs
authors.forename: David B
authors.initials: DB
authors.lastname: Ross
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Rebeyka
mesh_terms: D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000401:mortality; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009043:Motor Activity / Q000502:physiology; D011182:Postoperative Care; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D012044:Regression Analysis; D012189:Retrospective Studies