Long-term functional outcome of inpatient pediatric cardiopulmonary resuscitation

Torres, Adalberto; Pickert, Curtis B.; Firestone, Jennifer; Walker, Wanda M.; Fiser, Debra H.

doi:10.1097/00006565-199712000-00002

Cited by 53 publications

(10 citation statements)

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“…Estimates of neurological outcomes with PCPC scores allow more accurate power calculations for a hypothermia trial that proposes to use neurobehavioral outcome as a primary outcome measure. Relying on past literature alone, certain groups of patients such as those with sepsis as an etiology of cardiac arrest would likely be excluded from a trial of therapeutic hypothermia because of the extremely high mortality rates reported (4). However, in our in-hospital cardiac arrest cohort, 32.1 % of patients with septic shock as an etiology of arrest survived to hospital discharge justifying their inclusion in a clinical trial.…”

Section: Discussionmentioning

confidence: 99%

Multicenter cohort study of in-hospital pediatric cardiac arrest*

Meert

Donaldson

Nadkarni

et al. 2009

Pediatric Critical Care Medicine

208

122

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Objectives (1) Describe the clinical characteristics, hospital courses and outcomes of a cohort of children cared for within the Pediatric Emergency Care Applied Research Network (PECARN) who experienced in-hospital cardiac arrest with sustained return of circulation between July 1, 2003 and December 31, 2004, and (2) identify factors associated with hospital mortality in this population. These data are required to prepare a randomized trial of therapeutic hypothermia on neurobehavioral outcomes in children after in-hospital cardiac arrest. Design Retrospective cohort study. Setting Fifteen children’s hospitals associated with PECARN. Patients Patients between one day and 18 years of age who had cardiopulmonary resuscitation (CPR) and received chest compressions for >1 minute, and had a return of circulation for >20 minutes. Interventions None. Measurements and Main Results A total of 353 patients met entry criteria; 172 (48.7%) survived to hospital discharge. Among survivors, 132 (76.7%) had good neurological outcome documented by Pediatric Cerebral Performance Category scores. After adjustment for age, gender and first documented cardiac arrest rhythm, variables available prior to and during the arrest that were independently associated with increased mortality included pre-existing hematologic, oncologic, or immunologic disorders, genetic or metabolic disorders, presence of an endotracheal tube prior to the arrest, and the use of sodium bicarbonate during the arrest. Variables associated with decreased mortality included post-operative CPR. Extending the time frame to include variables available prior to, during, and within 12 hours following arrest, variables independently associated with increased mortality included the use of calcium during the arrest. Variables associated with decreased mortality included higher minimum blood pH and pupillary responsiveness. Conclusions Many factors are associated with hospital mortality among children after in-hospital cardiac arrest and return of circulation. Such factors must be considered when designing a trial of therapeutic hypothermia after cardiac arrest in pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Multicenter cohort study of in-hospital pediatric cardiac arrest*

Meert

Donaldson

Nadkarni

et al. 2009

Pediatric Critical Care Medicine

208

122

View full text Add to dashboard Cite

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“…Children experiencing in-hospital cardiac arrest probably have less morbidity than those with out-of-hospital cardiac arrests at hospital discharge (4) and 12 months later (21). Duncan et al (7) also reported "no severe neurologic disabilities" in children treated with rapid deployment ECMO after experiencing cardiac arrest, and favorable neurologic outcomes have been reported in a larger adult series of ECMO resuscitation from cardiac arrest (14).…”

Section: Discussionmentioning

confidence: 99%

Pediatric in-intensive-care-unit cardiac arrest: Incidence, survival, and predictive factors*

Mos

Litsenburg

McCrindle

et al. 2006

Critical Care Medicine

188

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“…Two early studies [4,5] have identified the long-term outcome of a diverse group of children admitted to a paediatric ICU. Long-term follow-up of children has been largely confined to select patient groups including children who have sustained a respiratory or cardiac arrest [6,7] or children with severe brain injury [8].…”

Section: Introductionmentioning

confidence: 99%