CPR quality and outcomes after extracorporeal life support for pediatric In-Hospital cardiac arrest

Stephanie R Brown¹, Maria Frazier², Joan Roberts³, Heather Wolfe⁴, Ken Tegtmeyer⁵, Robert Sutton⁴, Maya Dewan⁶; PediRES-Q Collaborative Investigators

Affiliations

¹ Section of Pediatric Critical Care Medicine, Oklahoma Children's Hospital, Oklahoma City, OK, USA; Division of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: stephanie-r-brown@ouhsc.edu.
² Division of Pediatric Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA.
⁴ Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
⁵ Division of Pediatric Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
⁶ Division of Pediatric Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

PMID: 37327853
PMCID: PMC12383489
DOI: 10.1016/j.resuscitation.2023.109874

Multicenter Study

CPR quality and outcomes after extracorporeal life support for pediatric In-Hospital cardiac arrest

Stephanie R Brown et al. Resuscitation. 2023 Aug.

. 2023 Aug:189:109874.

doi: 10.1016/j.resuscitation.2023.109874. Epub 2023 Jun 14.

Authors

Stephanie R Brown¹, Maria Frazier², Joan Roberts³, Heather Wolfe⁴, Ken Tegtmeyer⁵, Robert Sutton⁴, Maya Dewan⁶; PediRES-Q Collaborative Investigators

Affiliations

¹ Section of Pediatric Critical Care Medicine, Oklahoma Children's Hospital, Oklahoma City, OK, USA; Division of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: stephanie-r-brown@ouhsc.edu.
² Division of Pediatric Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ Division of Pediatric Critical Care Medicine, Seattle Children's Hospital, Seattle, WA, USA; Department of Pediatrics, University of Washington, Seattle, WA, USA.
⁴ Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
⁵ Division of Pediatric Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA.
⁶ Division of Pediatric Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

PMID: 37327853
PMCID: PMC12383489
DOI: 10.1016/j.resuscitation.2023.109874

Abstract

Aim of study: To determine outcomes in pediatric patients who had an in-hospital cardiac arrest and subsequently received extracorporeal cardiopulmonary resuscitation (ECPR). Our secondary objective was to identify cardiopulmonary resuscitation (CPR) event characteristics and CPR quality metrics associated with survival after ECPR.

Methods: Multicenter retrospective cohort study of pediatric patients in the pediRES-Q database who received ECPR after in-hospital cardiac arrest between July 1, 2015 and June 2, 2021. Primary outcome was survival to ICU discharge. Secondary outcomes were survival to hospital discharge and favorable neurologic outcome at ICU and hospital discharge.

Results: Among 124 patients included in this study, median age was 0.9 years (IQR 0.2-5) and the majority of patients had primarily cardiac disease (92 patients, 75%). Survival to ICU discharge occurred in 61/120 (51%) patients, 36/61 (59%) of whom had favorable neurologic outcome. No demographic or clinical variables were associated with survival after ECPR.

Conclusion: In this multicenter retrospective cohort study of pediatric patients who received ECPR for IHCA we found a high rate of survival to ICU discharge with good neurologic outcome.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation quality; Extracorporeal cardiopulmonary resuscitation; Paediatric intensive care unit.

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Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Dr. Sutton discloses that he receives funding from the National Heart, Lung and Blood Institute. All other authors confirm that they have no declarations of interest that could inappropriately bias this work.

References

1. Holmberg MJ, Ross CE, Fitzmaurice GM, et al. Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States. Circ Cardiovasc Qual Outcomes 2019;12:1–8. 10.1161/CIRCOUTCOMES.119.005580. - DOI - PMC - PubMed
1. Morgan RW, Kirschen MP, Kilbaugh TJ, Sutton RM, Topjian AA. Pediatric in-hospital cardiac arrest and cardiopulmonary resuscitation in the United States: a review. JAMA Pediatr 2021;175:293–302. 10.1001/jamapediatrics.2020.5039. - DOI - PMC - PubMed
1. Guerguerian AM, Sano M, Todd M, Honjo O, Alexander P, Raman L. Pediatric extracorporeal cardiopulmonary resuscitation ELSO guidelines. ASAIO J 2021:229–37. 10.1097/MAT.0000000000001345. - DOI - PubMed
1. Thiagarajan RR, Barbaro RP, Rycus PT, et al. Extracorporeal life support organization registry international report 2016. ASAIO J 2017;63:60–7. 10.1097/MAT.0000000000000475. - DOI - PubMed
1. Lasa J, Rogers R, Localio R, et al. Extracorporeal-cardiopulmonary resuscitation (E-CPR) during pediatric in-hospital cardiopulmonary arrest is associated with improved survival to discharge: a report from the American Heart Association’s Get With the Guidelines^®-Resuscitation Registry (GWTG-R). Circulation 2015;133:165–76. Available from: 10.1161/CIRCULATIONAHA.115.016082. - DOI - PMC - PubMed

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CPR quality and outcomes after extracorporeal life support for pediatric In-Hospital cardiac arrest

Affiliations

CPR quality and outcomes after extracorporeal life support for pediatric In-Hospital cardiac arrest

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials