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. 2009 Oct;80(10):1124-9.
doi: 10.1016/j.resuscitation.2009.07.004. Epub 2009 Aug 19.

Outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit

Parthak Prodhan  1 , Richard T Fiser, Umesh Dyamenahalli, Jeffrey Gossett, Michiaki Imamura, Robert D B Jaquiss, Adnan T Bhutta
Affiliations

Outcomes after extracorporeal cardiopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit

Parthak Prodhan et al. Resuscitation. 2009 Oct.

Abstract

Aim: To describe our experience using extracorporeal cardiopulmonary resuscitation (ECPR) in resuscitating children with refractory cardiac arrest in the intensive care unit (ICU) and to describe hospital survival and neurologic outcomes after ECPR.

Methods: A retrospective chart review of a consecutive case series of patients requiring ECPR from 2001 to 2006 at Arkansas Children's Hospital. Data from medical records was abstracted and reviewed. Primary study outcomes were survival to hospital discharge and neurological outcome at hospital discharge.

Results: During the 6-year study period, ECPR was deployed 34 times in 32 patients. 24 deployments (73%) resulted in survival to hospital discharge. Twenty-eight deployments (82%) were for underlying cardiac disease, 3 for neonatal non-cardiac (NICU) patients and 3 for paediatric non-cardiac (PICU) patients. On multivariate logistic regression analysis, only serum ALT (p-value=0.043; OR, 1.6; 95% confidence interval, 1.014-2.527) was significantly associated with risk of death prior to hospital discharge. Blood lactate at 24h post-ECPR showed a trend towards significance (p-value=0.059; OR, 1.27; 95% confidence interval, 0.991-1.627). The Hosmer-Lemeshow tests (p-value=0.178) suggested a good fit for the model. Neurological evaluation of the survivors revealed that there was no change in PCPC scores from a baseline of 1-2 in 18/24 (75%) survivors.

Conclusions: ECPR can be used successfully to resuscitate children following refractory cardiac arrest in the ICU, and grossly intact neurologic outcomes can be achieved in a majority of cases.

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Conflict of interest statement

Conflict of interest statement

None of the authors have any conflict of interest that could inappropriately influence (bias) this work.

Figures

Figure 1
Figure 1
Distribution of ECPR cases and survival by calendar year
See this image and copyright information in PMC

References

    1. Schindler MB, Bohn D, Cox PN, et al. Outcome of out-of-hospital cardiac or respiratory arrest in children. N Engl J Med. 1996;335:1473–1479. - PubMed
    1. Slonim AD, Patel KM, Ruttimann UE, Pollack MM. Cardiopulmonary resuscitation in pediatric intensive care units. Crit Care Med. 1997;25:1951–1955. - PubMed
    1. Reis AG, Nadkarni V, Perondi MB, et al. A prospective investigation into the epidemiology of in-hospital pediatric cardiopulmonary resuscitation using the international Utstein reporting style. Pediatrics. 2002;109:200–209. - PubMed
    1. Suominen P, Olkkola KT, Voipio V, et al. Utstein style reporting of in-hospital pediatric cardiopulmonary resuscitation. Resuscitation. 2000;45:17–25. - PubMed
    1. Nadkarni VM, Larkin GL, Peberdy MA, et al. National Registry of Cardiopulmonary Resuscitation Investigators. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA. 2006;4(295):50–57. - PubMed

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