Maayke Hunfeld

81 Survey neuroprognostication Figure 2. Methods considered as most useful in order to prognosticate CT=computed tomography, EEG=electroencephalography, MRI= magnetic resonance imaging, NIRS=near infrared spectroscopy, SSEP= somato sensory evoked potential. Thirty-five respondents (50%) considered a Pediatric Cerebral Performance Category (PCPC) score of ≥ 4 (at least severe neurological disability) at hospital discharge as a poor outcome and 8 (11%) a PCPC score of ≥ 3 (Table 3a). Eleven respondents (15%) considered a difference of ≥ 2 between PCPC score at baseline and after CA as poor neurological outcome. Timing of determining neurological prognosis varied from within 48 h after CA (8%) up to beyond 14 days (10%), whereby 63% indicated that individual patient characteristics were also taken into account (Table 3a). Both intensivist and paediatric neurologist were mostly primary responsible (resp. 69% and 83%) for determining neurological prognosis. Once decided that neurological prognosis was futile, 55% of the respondents (N=39) indicated that WLST was one of the options, whereas 44% continued PICU treatment with or without restrictions (Table 3a). The practices in PICUs in the different areas of Europe regarding WLST or continuing treatment when prognosis is futile are shown in figure 3. Ten percent answered that an ethicist was routinely involved in cases in which an end-of-life decision was discussed and 70% answered that an ethicist was consulted on individual basis (Table 3a). The differences in opinion between paediatric intensivists and paediatric neurologists regarding the definition of a poor outcome, timing of determining prognosis, consequences of a poor outcome and involvement of an ethicist are shown in table 3b. 3