Epidemiology and outcome analysis of children with traumatic out-of-hospital cardiac arrest compared to nontraumatic cardiac arrest

Chen, Chun Yu; Lin, Yan Ren; Zhao, Lu; Wu, Yao‐Kuang; Chang, Yu-Jun; Yang, Weiming; Wu, Kang Hsi; Wu, Han

doi:10.1007/s00383-013-3302-z

Cited by 14 publications

(26 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The finding is consistent with the result from a previous study at our center29 as well as other studies reporting that pediatric patients are at a higher risk for cardiac arrest and higher morbidity in the peri- and postoperative periods in traumatic cases. It was also reported that pediatric patients with high ASA physical status classification suffering from injury before receiving anesthesia had a higher cardiac arrest and comorbidity rate 1–3,11,18,30. Several factors may explain this increased risk of cardiac arrest in pediatric patients, including severe comorbidities of the cardiovascular and/or respiratory systems, restrictions on drug administration, increased sensitivity to oxygen desaturation, sensitivity in the airways, difficult airway management, and increased sensitivity to changes in the circulatory and/or respiratory systems.…”

Section: Discussionmentioning

confidence: 98%

“…Such cases involve high blood loss prior to hospital arrival, possibly unknown to the surgery and anesthesia teams. Many studies have shown that traumatic cases with high morbidity also involve blood loss 3,18,30. In one study, the highest cardiac arrest rates occurred in cases involving intraoperative transfusion, traumatic cases, poor ASA physical status classification, and emergency surgery 3,6,15.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

Siriphuwanun¹,

Punjasawadwong²,

Lapisatepun³

et al. 2014

RMHP

View full text Add to dashboard Cite

PurposeTo determine the incidence of and factors associated with perioperative cardiac arrest within 24 hours of receiving anesthesia for emergency surgery.Patients and methodsThis retrospective cohort study was approved by the ethical committee of Maharaj Nakorn Chiang Mai Hospital, Thailand. We reviewed the data of 44,339 patients receiving anesthesia for emergency surgery during the period from January 1, 2003 to March 31, 2011. The data included patient characteristics, surgical procedures, American Society of Anesthesiologists (ASA) physical status classification, anesthesia information, location of anesthesia performed, and outcomes. Data of patients who had received topical anesthesia or monitoring anesthesia care were excluded. Factors associated with cardiac arrest were identified by univariate analyses. Multiple regressions for the risk ratio (RR) and 95% confidence intervals (CI) were used to determine the strength of factors associated with cardiac arrest. A forward stepwise algorithm was chosen at a P-value <0.05.ResultsThe incidence (within 24 hours) of perioperative cardiac arrest in patients receiving anesthesia for emergency surgery was 163 per 10,000. Factors associated with 24-hour perioperative cardiac arrest in emergency surgery were age of 2 years or younger (RR =1.46, CI =1.03–2.08, P=0.036), ASA physical status classification of 3–4 (RR =5.84, CI =4.20–8.12, P<0.001) and 5–6 (RR =33.98, CI =23.09–49.98, P<0.001), the anatomic site of surgery (upper intra-abdominal, RR =2.67, CI =2.14–3.33, P<0.001; intracranial, RR =1.74, CI =1.35–2.25, P<0.001; intrathoracic, RR =2.35, CI =1.70–3.24, P<0.001; cardiac, RR =3.61, CI =2.60–4.99, P<0.001; and major vascular; RR =3.05, CI =2.22–4.18, P<0.001), respiratory or cardiovascular comorbidities (RR =1.95, CI =1.60–2.38, P<0.001 and RR =1.38, CI =1.11–1.72, P=0.004, respectively), and patients in shock prior to receiving anesthesia (RR =2.62, CI =2.07–3.33, P<0.001).ConclusionThe perioperative incidence of cardiac arrest within 24 hours of anesthesia for emergency surgery was high and associated with multiple factors such as young age (≤2 years old), cardiovascular and respiratory comorbidities, increasing ASA physical status classification, preoperative shock, and surgery site. Perioperative care providers, including surgeons, anesthesiologists, and nurses, should be prepared to manage promptly this high risk group of surgical patients.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

Siriphuwanun¹,

Punjasawadwong²,

Lapisatepun³

et al. 2014

RMHP

View full text Add to dashboard Cite

show abstract

“…Survival among infants has been documented between 1.4% and 1.7% . In contrast, overall survival in children of all age groups is generally slightly higher, although varying widely (2.0–12.1%) with median of 8% . In comparison, in‐hospital arrests have a better outcome with 48.5–62% achieving return of spontaneous circulation (ROSC) and 15.4–48.7% surviving to discharge …”

Section: Introductionmentioning

confidence: 99%

Out‐of‐hospital arrests attending an Australian tertiary paediatric emergency department over 13 years: An observational study

Day

Hort

2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

“…2,4,5 Previous studies have reported factors that are associated with survival in children with traumatic OHCA, such as hypoxia-caused arrest, prehospital resuscitation course, witness presence, shorter transportation duration, and inhospital resuscitation. 1,2,5,9,10 However, the contribution of medication (ie, epinephrine) for pediatric resuscitation has not been well documented.…”

Section: Introductionmentioning

confidence: 99%

Impact of Different Initial Epinephrine Treatment Time Points on the Early Postresuscitative Hemodynamic Status of Children With Traumatic Out-of-hospital Cardiac Arrest

et al. 2016

Self Cite

View full text Add to dashboard Cite

The postresuscitative hemodynamic status of children with traumatic out-of-hospital cardiac arrest (OHCA) might be impacted by the early administration of epinephrine, but this topic has not been well addressed. The aim of this study was to analyze the early postresuscitative hemodynamics, survival, and neurologic outcome according to different time points of first epinephrine treatment among children with traumatic OHCA.Information on 388 children who presented to the emergency departments of 3 medical centers and who were treated with epinephrine for traumatic OHCA during the study period (2003–2012) was retrospectively collected. The early postresuscitative hemodynamic features (cardiac functions, end-organ perfusion, and consciousness), survival, and neurologic outcome according to different time points of first epinephrine treatment (early: <15, intermediate: 15–30, and late: >30 minutes after collapse) were analyzed.Among 165 children who achieved sustained return of spontaneous circulation, 38 children (9.8%) survived to discharge and 12 children (3.1%) had good neurologic outcomes. Early epinephrine increased the postresuscitative heart rate and blood pressure in the first 30 minutes, but ultimately impaired end-organ perfusion (decreased urine output and initial creatinine clearance) (all P < 0.05). Early epinephrine treatment increased the chance of achieving sustained return of spontaneous circulation, but did not increase the rates of survival and good neurologic outcome.Early epinephrine temporarily increased heart rate and blood pressure in the first 30 minutes of the postresuscitative period, but impaired end-organ perfusion. Most importantly, the rates of survival and good neurologic outcome were not significantly increased by early epinephrine administration.

show abstract

Epidemiology and outcome analysis of children with traumatic out-of-hospital cardiac arrest compared to nontraumatic cardiac arrest

Cited by 14 publications

References 19 publications

Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

Incidence of and factors associated with perioperative cardiac arrest within 24 hours of anesthesia for emergency surgery

Out‐of‐hospital arrests attending an Australian tertiary paediatric emergency department over 13 years: An observational study

Impact of Different Initial Epinephrine Treatment Time Points on the Early Postresuscitative Hemodynamic Status of Children With Traumatic Out-of-hospital Cardiac Arrest

Contact Info

Product

Resources

About