Maayke Hunfeld

253 General discussion UNRESOLVED PROBLEMS 7. Prediction models with the purpose to predict outcome in children after OHCA do not exist so far. Unresolved problem 7. Potential solution 7. International collaboration The potential solution of this unsolved problem overlaps to some extent with the potential solution of problem 1. By creating national and international collaboration, standardized care can be developed, preferably with a high level of evidence by using the Delphi technique – not only with medical experts, but also with involvement of parents (95). All patient data (pre-OHCA, OHCA and post-OHCA data) can be collected in an electronic database and analyzed. This way guidelines and prediction models can be developed. An existing international collaboration, which offers opportunities to develop a prediction model, is PediRES-Q, in which our PICU department participates. Various international observational CA studies are generated from the PediRES-Q with large sample sizes. Even if a prediction model can be developed, we must keep in mind that it should never be at the expense of individualized patient care. Future research plans (Erasmus MC) Investigate psychosocial functioning, QoL and participation in pediatric OHCA survivors and their parents Investigate outcome of pediatric OHCA survivors at the ages of 5,8,12 and 17 years Investigate long-term outcome of pediatric OHCA survivors at the age of 23-30 years Development and implementation of a support program for parents and siblings of pediatric OHCA survivors Investigate the potential predictive role of quantitative MRI (DTI) in children after OHCA Investigate the role of QEEG in the prediction of outcome after OHCA by designing a machine learning algorithm for cEEGs in children admitted at our PICU after OHCA (together with Delft University of Technology) Investigate intervention methods at the short term, such as AAC strategies, and at the long term, VR and computer-based intervention programs, together with Delft University of Technology and Rijndam Rehabilitation Center with the aim to improve outcome of pediatric OHCA survivors. Table 3. Summary of future research plans Erasmus MC AAC= augmentative and alternative communication; cEEG= continuous electroencephalography; DTI= diffusion tensor imaging; MRI= Magnetic resonance imaging; OHCA= Out-of-hospital cardiac arrest; PICU= Pediatric Intensive Care Unit; QEEG= Qualitative electroencephalography; QoL= Quality of life; VR= Virtual reality 8