Maayke Hunfeld

79 Survey neuroprognostication 3.3 Neuro-prognostication One nation had a national guideline for neuro-prognostication after paediatric CA, whereas 8 PICUs (20%) had a local guideline (Appendix B, supplementary table S2). To assess the level of consciousness, 92% of respondents used at least the Glasgow Coma Score (GCS) (Appendix B, supplementary table S4) and 75% brainstem reflexes. Sixty-seven percent of the respondents performed neurological examination more than once a day. Both physicians and nurses performed neurological examination (Appendix B, supplementary table S4.). Sixty-six percent performed a brain MRI in routine clinical practice between day 1-7 after CA. Eight respondents (11%) replied not to use MRI (Table 2). Thirty-four percent used a routine EEG and 38% a continuous EEG (cEEG) in order to prognosticate, the timing of EEG registrations differed (Table 2). Ninety-four percent of the respondents used at least one test besides neurological examination for neuro-prognostication. The three methods considered as most useful to predict neurological outcome, according to paediatric intensivist and paediatric neurologist, were: neurological examination (resp 91% and 90%), MRI brain (resp 78% and 87%) and cEEG (resp 53% and 39%) (figure 2). No. of respondents Frequency % EEG 1 (N=71) No 19 (27) Routine 2 < 24 hours 10 (14) Routine > 24 hours 14 (20) Continuous 3 < 24 hours 18 (25) Continuous > 24 hours 9 (13) Depends on treating physician 12 (17) Other Unknown 3 (4) 1 (1) MRI 1 (N=71) No 8 (11) < 24 hours 5 (7) Between day 1 – 3 18 (25) Between day 4 – 7 29 (41) > 7 days 4 (6) Timing differs 15 (21) Depends on treating physician Unknown 4 (6) 1 (1) 3