الفهرس 
pathophysiology of cardiac arrestOnly 14 pages are availabe for public view
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Abstract
Brain damage is one of the major causes of morbidity and mortality after cardiac arrest and cardiopulmonary resuscitation in pediatric patients.
Clinical scales often fail to adequately reflect the actual prognosis, because many resuscitated patients are still under analgesia and sedation.
Previous studies on CNS specific proteins indicated that (S100B) which is part of a large family of Ca++ binding proteins found in Astrocytes and Schwann cells, is highly relevant for assessing the outcome of patients with hypoxic ischemic encephalopathy.
The present study aimed at determination of the prognostic value of serum S100B level at day 1 and day 2 as regards neurological outcome after cardiopulmonary arrest in PICU.
The study was conducted in PICU of Ain Shams University Hospital from March to October, 2006. It included 33 critically ill patients and 20 healthy infants as a control group with mean age (15.3 9.2 and 14.9 8.9 months) respectively. They were 20 females and 15 males.
All patients and controls were subjected to full history taking and through clinical examination, patients with neurological problems before cardiopulmonary arrest (CPA) were excluded from the study.
Full details of CPR were reported (time of arrest, duration of resuscitation, medication used during resuscitation).
Within 6 hours after CPR and 24 hours later all patients were subjected to the following: Pediatric risk of mortality (PRISMIII) scoring, Glasgow coma score (GCS),. Sequential organ failure assessment (Sofa score), full neurological evaluation which classified patients into a group with good outcome (20 patients) and a group with poor outcome (13 patients), blood sampling, follow-up of the fate of the patients which classified them into survivors (18 patients) and non-survivors (15 patients).
Our patients were admitted to PICU due to bronchopneumonia in (12 patients), congenital heart disease in (7 patients), bronchiolitis in (6 patients), gastroenteritis in (5 patients), complication of malnutrition in (2 patients), and sepsis in (one patient).
The main results of the present study were as follows:
Comparison between patients and control showed the following:
There were highly significant difference between patients and control as regards all CBC parameter and blood chemistry parameter except for urea which was non-significant.
There is significant difference between first sample of patients versus control, also between the second sample versus control as regards S100B level in serum.
Comparison between patients with good neurological outcome and patients with poor neurological outcome showed the following
As regards CBC parameters, there were non-significant difference between them in all parameters except for Staff, which was significant.
As regards blood chemistry, there were highly significant difference between them in 3parameters (Alb, PTT, CRP), significant difference between them in 3 parameters (Bil, AST, PT) and non-significant difference between them in 5 parameters (Urea, Creat, ALT, Na and K).
As regards percentage of change of the (Sofa, GCS, Prism III, S100B), there were highly significant increase in the percentage of change of (Prism III, GCS, S100B) in patients with good neurological outcome when compared to patients with poor neurological outcome.
Comparison between survivors and non-survivors showed the following:
As regards CBC parameters, there were non-significant difference between them in all parameters except for (Staff) which was significant.
As regards blood chemistry, there were highly significant difference between them in 3 parameters (Albumin level, PTT, CRP), there were significant difference between them in 3 parameters (Billirubin , AST, PT). Finally, there were non-significant difference between them in 5 parameters (Urea, Creatinine, ALT, Na, K).
As regards percentage of change of (Sofa, GCS, Prism III, S100B), there were highly significant difference between them in the percentage of change (GCS, Prism III), there were significant difference between them in percentage of change of Sofa and as for S100B level percentage of change, it was insignificantly higher among non-survivors.