PURPOSE To describe current practices in European Paediatric Intensive Care Units (PICUs) regarding neuro-prognostication in comatose children after cardiac arrest (CA). METHODS An anonymous online survey was conducted among members of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC) and the European Paediatric Neurology Society (EPNS) throughout January and February 2019. The survey consisted of 49 questions divided into 4 sections: general information, cardiac arrest, neuro-prognostication and follow-up. RESULTS The survey was sent to 1310 EPNS and 611 ESPNIC members. Of the 108 respondents, 71 (66%) (23 countries, 45 PICUs) completed the "neuro-prognostication" section. Eight PICUs (20%) had a local neuro-prognostication guideline. The 3 methods considered as most useful were neurological examination (92%), magnetic resonance imaging (MRI) (82%) and continuous electroencephalography (cEEG) (45%). In 50% a Pediatric Cerebral Performance Category (PCPC) score ≥ 4 was considered as poor neurological outcome. In 63% timing of determining neurological prognosis was based on the individual patient. Once decided that neurological prognosis was futile, 55% indicated that withdrawing life-sustaining therapy (WLST) was (one of) the options, whereas 44% continued PICU treatment (with or without restrictions). In 28 PICUs (68%) CA-survivors were scheduled for follow-up visits. CONCLUSION Local guidelines for neuro-prognostication in comatose children after CA are uncommon. Methods to assess neurological outcome were mainly neurological examination, MRI and cEEG. Consequences of poor outcome differed between respondents. Inaccuracies in neuro-prognostication can result in premature WLST, thereby biasing outcome research and creating a self-fulfilling cycle. Further research is needed to develop scientifically based international guidelines for neuro-prognostication in comatose children after CA.

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目前关于心脏骤停后昏迷儿童神经预后的实践在欧洲 PICU 之间和内部有所不同：一项调查

目的 描述欧洲儿科重症监护病房 (PICU) 中关于心脏骤停 (CA) 后昏迷儿童神经预后的当前做法。方法 2019 年 1 月和 2 月，在欧洲儿科和新生儿重症监护学会 (ESPNIC) 和欧洲儿科神经病学学会 (EPNS) 的成员中进行了一项匿名在线调查。调查包括 49 个问题，分为 4 个部分：一般信息、心脏骤停、神经预后和随访。结果 调查发送给 1310 名 EPNS 和 611 名 ESPNIC 成员。在 108 名受访者中，71 人 (66%)（23 个国家/地区，45 个 PICU）完成了“神经预后”部分。8 个 PICU (20%) 有本地神经预后指南。被认为最有用的 3 种方法是神经系统检查 (92%)、磁共振成像 (MRI) (82%) 和连续脑电图 (cEEG) (45%)。在 50% 的小儿脑功能分类 (PCPC) 评分 ≥ 4 中，被认为是不良的神经系统结果。确定神经学预后的 63% 时间是基于个体患者。一旦确定神经系统预后无效，55% 的人表示停止生命维持治疗 (WLST) 是（其中一种）选择，而 44% 的人继续 PICU 治疗（有或没有限制）。在 28 个 PICU (68%) 中，CA 幸存者被安排进行随访。结论 当地关于 CA 后昏迷儿童神经预后的指南并不常见。评估神经系统结果的方法主要是神经系统检查、MRI和cEEG。结果不佳的后果因​​受访者而异。神经预测的不准确可能导致过早的 WLST，从而使结果研究产生偏差并形成自我实现的循环。需要进一步的研究来制定以科学为基础的 CA 后昏迷儿童神经预后国际指南。