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Episode 49 | Pediatric Cardiac Arrest with Dr. Beth Slomine


Overview

There is a growing need for neuropsychologists in an inpatient rehab setting and throughout follow-up care for children who are resuscitated after experiencing a cardiac arrest. Today, we talk with Beth Slomine, Ph.D., ABPP-CN, about the risks and benefits associated with therapeutic hypothermia for these children, and her involvement in the THAPCA multi-site trial.



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Beth Slomine
Instructor Credentials

Dr. Beth Slomine is co-director of the Center for Brain Injury Recovery and director of neuropsychology training and neuropsychological rehabilitation services at Kennedy Krieger Institute. She is an associate professor of Psychiatry & Behavioral Sciences and Physical Medicine & Rehabilitation at Johns Hopkins University School of Medicine. She is a licensed psychologist, board certified clinical neuropsychologist, and board-certified subspecialist in pediatric neuropsychology. Research interests include developing neurobehavioral assessment tools and understanding factors influencing outcome following pediatric neurological injury. Dr. Slomine has authored more than 70 peer-reviewed manuscripts, numerous book chapters, and co-edited a textbook entitled Cognitive Rehabilitation for Pediatric Neurological Conditions.


Topics Covered
  • Defining terminology - cardiac arrest, hypothermia, normothermia, and therapeutic hypothermia after pediatric cardiac arrest (THAPCA)
  • Beth discusses how cardiac arrest impacts brain functioning
  • She also explains the risks and benefits associated with THAPCA
  • Delayed access to medical care is the strongest predictor of poor outcomes in pediatric cardiac arrest
  • Beth suggests that children with in-hospital and out-of-hospital cardiac arrest are distinct populations due to outcome differences
  • Sampling bias is a significant limitation in THAPCA clinical trials
  • Beth discusses important ethical considerations of withholding therapeutic hypothermia
  • Preexisting factors associated with survival rate and neurobehavioral outcomes in THAPCA
  • Cognitive functioning in pediatric cardiac arrest
  • Beth explains the role of a neuropsychologist in an interdisciplinary medical team
  • Bonus questions
Educational Objectives
  • Define and distinguish cardiac arrest and heart attack.
  • Discuss the utility of targeted temperature management for pediatric cardiac arrest.
  • Describe the design and results of the therapeutic hypothermia after pediatric cardiac arrest (THAPCA) trial.
  • Identify the predictors of poor outcomes in pediatric cardiac arrest.
  • List two preexisting factors associated with survival and neurobehavioral outcomes in THAPCA.
  • Apply knowledge about pediatric cardiac arrest and therapeutic hypothermia in clinical evaluations with children.
Target Audience
  • Introductory
Availability
  • Date Available: 2021-05-03
  • You may obtain CE for this podcast at any time.
Offered for CE
  • Yes
Cost
  • Members $20
  • Non-Members $25
Refund Policy
  • This podcast is not eligible for refunds
CE Credits
  • 1.0 Credit(s)
Disclosures
  • N/A
Resources
  • N/A
Bibliography
  • Holubkov, R., Clark, A. E., Moler, F. W., Slomine, B. S., Christensen, J. R., Silverstein, F. S., et al. (2015). Efficacy outcome selection in the therapeutic hypothermia after pediatric cardiac arrest trials. Pediatr Crit Care Med, 16(1), 1-10.
  • Moler, F. W., Silverstein, F. S., Meert, K. L., Clark, A. E., Holubkov, R., Browning, B., et al. (2013). Rationale, timeline, study design, and protocol overview of the therapeutic hypothermia after pediatric cardiac arrest trials. Pediatr Crit Care Med, 14(7), e304-315.
  • Pemberton, V. L., Browning, B., Webster, A., Dean, J. M., & Moler, F. W. (2013). Therapeutic hypothermia after pediatric cardiac arrest trials: the vanguard phase experience and implications for other trials. Pediatr Crit Care Med, 14(1), 19-26.
  • Schmitt, K. R., Tong, G., & Berger, F. (2014). Mechanisms of hypothermia-induced cell protection in the brain. Mol Cell Pediatr, 1(1), 7.
  • Slomine, B. S., Silverstein, F. S., Christensen, J. R., Holubkov, R., Page, K., Dean, J. M., et al. (2016). Neurobehavioral Outcomes in Children After Out-of-Hospital Cardiac Arrest. Pediatrics, 137(4).
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