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
. 2024 Oct 20;12(10):261.
doi: 10.3390/diseases12100261.

Clinical Significance of Whole-Body Computed Tomography Scans in Pediatric Out-of-Hospital Cardiac Arrest Patients Without Prehospital Return of Spontaneous Circulation

Masanori Ishida  1 , Taro Tanaka  1 , Shinichiro Morichi  2 , Hirotaka Uesugi  3 , Haruka Nakazawa  2 , Shun Watanabe  2 , Motoki Nakai  1 , Gaku Yamanaka  2 , Hiroshi Homma  3 , Kazuhiro Saito  1
Affiliations

Clinical Significance of Whole-Body Computed Tomography Scans in Pediatric Out-of-Hospital Cardiac Arrest Patients Without Prehospital Return of Spontaneous Circulation

Masanori Ishida et al. Diseases. .

Abstract

Background. Whole-body computed tomography (WBCT) is commonly employed for primary screening in pediatric patients experiencing out-of-hospital cardiac arrest (OHCA) without prehospital return of spontaneous circulation (ROSC). This study aimed to evaluate the cause of OHCA on WBCT and compare WBCT findings between ROSC and non-ROSC groups in non-traumatic pediatric OHCA cases in an emergency department setting. Methods. A retrospective analysis was conducted on 27 pediatric patients (mean age: 32.4 months; median age: 10 months) who experienced non-traumatic OHCA without prehospital ROSC and were transported to our tertiary care hospital between January 2013 and December 2023. WBCT scans were performed to investigate the cause of OHCA, with recorded findings in the head, chest, abdomen, and subcutaneous tissues. Results. In all cases, the direct causes of OHCA were undetermined, and WBCT identified no fatal findings. Statistical comparisons of CT findings between the ROSC and non-ROSC groups revealed significant differences. The non-ROSC group had a higher incidence of brain swelling, loss of cerebral gray-white matter differentiation, symmetrical lung consolidation/ground-glass opacity, cardiomegaly, hyperdense aortic walls, narrowed aorta, gas in the mediastinum, and hepatomegaly compared to the ROSC group. Conclusions. Although WBCT did not reveal the direct cause of OHCA, several CT findings were significantly more frequent in the non-ROSC group, including brain swelling, loss of cerebral gray-white matter differentiation, symmetrical lung consolidation/ground-glass opacity, cardiomegaly, hyperdense aortic wall, narrowed aorta, gas in the mediastinum, and hepatomegaly. These findings, resembling postmortem changes, may aid in clinical decision making regarding the continuation or cessation of resuscitation efforts in pediatric OHCA cases.

Keywords: computed tomography; out-of-hospital cardiac arrest; pediatric patient; return of spontaneous circulation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Nine-month-old boy with non-ROSC (case No. 19 in Table S1). (a) Observations in the head included brain swelling, loss of cerebral gray-white matter differentiation, and hyperdense intracranial venous sinus (arrows). (b) Symmetrical consolidation/ground-glass opacity of the lungs was noted. (c) In the mediastinum, findings included cardiomegaly, a hyperdense aortic wall (arrows), and gas in the cardiac cavity (arrowheads). (d) A narrowed aorta (arrow) and hepatomegaly were observed.
Figure 1
Figure 1
Nine-month-old boy with non-ROSC (case No. 19 in Table S1). (a) Observations in the head included brain swelling, loss of cerebral gray-white matter differentiation, and hyperdense intracranial venous sinus (arrows). (b) Symmetrical consolidation/ground-glass opacity of the lungs was noted. (c) In the mediastinum, findings included cardiomegaly, a hyperdense aortic wall (arrows), and gas in the cardiac cavity (arrowheads). (d) A narrowed aorta (arrow) and hepatomegaly were observed.
Figure 2
Figure 2
Four-month-old boy with ROSC (case No. 6 in Table S2). (a) No symmetrical or asymmetrical lung consolidation/ground-glass opacity of the lungs was observed. (b) In the mediastinum, mild cardiomegaly was noted, but no hyperdense aortic wall was identified. (c) A dilated gastrointestinal tract was observed.
See this image and copyright information in PMC

References

    1. Tokyo Households and Population (by Town/Village and Age) by Basic Resident Ledger; Statistics Division, Bureau of General Affairs, Tokyo Metropolitan Government. 2024. [(accessed on 25 August 2024)]. Available online: https://www.toukei.metro.tokyo.lg.jp/juukiy/2024/jy24qf0001.pdf.
    1. Current Status of Emergency Services 2022; Tokyo Fire Department. 2023. [(accessed on 25 August 2024)]. Available online: https://www.tfd.metro.tokyo.lg.jp/hp-kyuukanka/katudojitai/data/pdf/R2_2....
    1. Numaguchi A., Mizoguchi F., Aoki Y., An B., Ishikura A., Ichikawa K., Ito Y., Uchida Y., Umemoto M., Ogawa Y., et al. Epidemiology of Child Mortality and Challenges in Child Death Review in Japan: The Committee on Child Death Review: A Committee Report: The Committee on Child Death Review: A Committee Report. Pediatr. Int. 2022;64:e15068. doi: 10.1111/ped.15068. - DOI - PMC - PubMed
    1. Kreutz J., Patsalis N., Müller C., Chatzis G., Syntila S., Sassani K., Betz S., Schieffer B., Markus B. EPOS-OHCA: Early Predictors of Outcome and Survival after Non-Traumatic Out-of-Hospital Cardiac Arrest. Resusc. Plus. 2024;19:100728. doi: 10.1016/j.resplu.2024.100728. - DOI - PMC - PubMed
    1. Survey on the Search for Causes of Pediatric Out-of-Hospital Cardiac Arrest; Japan Pediatric Association. [(accessed on 25 August 2024)]. Available online: https://www.jpeds.or.jp/uploads/files/20240729_ingai_hokoku.pdf. (In Japanese)

LinkOut - more resources