Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 11:13:100354.
doi: 10.1016/j.resplu.2022.100354. eCollection 2023 Mar.

Factors associated with survival and neurologic outcome after in-hospital cardiac arrest in children: A cohort study

Tania M Shimoda-Sakano  1 , Edison F Paiva  2 , Cláudio Schvartsman  1 , Amelia G Reis  1
Affiliations

Factors associated with survival and neurologic outcome after in-hospital cardiac arrest in children: A cohort study

Tania M Shimoda-Sakano et al. Resusc Plus. .

Abstract

Aim: In-hospital paediatric cardiopulmonary resuscitation (CPR) survival has been improving in high-income countries. This study aimed to analyse factors associated with survival and neurological outcome after paediatric CPR in a middle-income country.

Methods: This observational study of in-hospital cardiac arrest using Utstein-style registry included patients <18 years old submitted to CPR between 2015 and 2020, at a high-complexity hospital. Outcomes were survival and neurological status assessed using Paediatric Cerebral Performance Categories score at prearrest, discharge, and after 180 days.

Results: Of 323 patients who underwent CPR, 108 (33.4%) survived to discharge and 93 (28.8%) after 180 days. In multivariable analysis, lower survival at discharge was associated with liver disease (OR 0.060, CI 0.007-0.510, p = 0.010); vasoactive drug infusion before cardiac arrest (OR 0.145, CI 0.065-0.325, p < 0.001); shock as the immediate cause (OR 0.183, CI 0.069-0.486, p = 0.001); resuscitation > 30 min (OR 0.070, CI 0.014-0.344, p = 0.001); and bicarbonate administration during CPR (OR 0.318, CI 0.130-0.780, p = 0.01). The same factors remained associated with lower survival after 180 days. Neurological outcome was analysed in the 93 survivors after 180 days following CPR. Prearrest neurological dysfunction was observed in 31.4%, and neurological prognosis was favourable in 79.7% at discharge and similar after 180 days.

Conclusion: In-hospital paediatric cardiac arrest patients with complex chronic conditions had lower survival associated with liver disease, shock as cause of cardiac arrest, vasoactive drug infusion before cardiac arrest, bicarbonate administration during CPR, and prolonged resuscitation. Most survivors had favourable neurological outcome.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; In-hospital cardiac arrest; Neurological outcome; Pediatric; Prognostic factors.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Patient inclusion flowchart and neurological outcome. CPR: cardiopulmonary resuscitation, ROSC: return of spontaneous circulation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Nadkarni V.M., Larkin G.L., Peberdy M.A., et al. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA. 2006;295:50–57. - PubMed
    1. Holmberg M.J., Ross C.E., Fitzmaurice G.M., et al. Annual Incidence of Adult and Pediatric In-Hospital Cardiac Arrest in the United States. Circ Cardiovasc Qual Outcomes. 2019;12:e005580. - PMC - PubMed
    1. Reis A.G., Nadkarni V., Perondi M.B., Grisi S., Berg R.A. 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. López-Herce J., Del Castillo J., Matamoros M., et al. Factors associated with mortality in pediatric in-hospital cardiac arrest: a prospective multicenter multinational observational study. Intensive Care Med. 2013;39:309–318. - PubMed
    1. Del Castillo J., López-Herce J., Matamoros M., et al. Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study. Resuscitation. 2015;96:126–134. - PubMed

LinkOut - more resources