Related Experiment Video
Updated: Jul 18, 2026
Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest
Published on: May 26, 2023
Higher survival rates among younger patients after pediatric intensive care unit cardiac arrests
Peter A Meaney1, Vinay M Nadkarni, E Francis Cook
1Department of Critical Care Medicine, 7th Floor, Room 7c03, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA. Meaney@email.chop.edu
Insights
Infants and newborns show significantly better survival rates after pediatric intensive care unit (ICU) cardiac arrests compared to older children. This age-dependent survival highlights critical differences in pediatric resuscitation outcomes.
Area of Science:
- Pediatric critical care medicine
- Resuscitation science
- Pediatric emergency medicine
Background:
- Age is a known factor in adult cardiac arrest outcomes, but its role in pediatric cardiac arrests is less understood, except in premature infants.
- Infants' increased chest wall compliance may facilitate more effective blood flow during chest compressions compared to older children and adults.
- Previous research has not definitively established age as a key determinant of survival in pediatric cardiac arrest scenarios.
Purpose of the Study:
- To investigate the association between age and survival outcomes in pediatric patients experiencing cardiac arrest within an intensive care unit (ICU) setting.
- To determine if infants and newborns have different survival rates compared to older children following ICU cardiac arrest.
- To analyze age-specific survival data from a large national registry of pediatric cardiopulmonary resuscitation.
Main Methods:
- Evaluation of 464 pediatric ICU cardiac arrests from the National Registry of Cardiopulmonary Resuscitation (2000-2002), excluding neonatal intensive care unit (NICU) arrests.
- Categorization of patient age into four groups: newborn (<1 month), infant (1 month to <1 year), younger child (1 year to <8 years), and older child (8 years to <21 years).
- Application of multivariable logistic regression to analyze the relationship between age categories and survival to hospital discharge, controlling for potential confounders.
Main Results:
- Overall survival to hospital discharge was 22%, with variations across age groups: newborns (27%), infants (36%), younger children (19%), and older children (16%).
- Newborns and infants demonstrated significantly higher odds of survival compared to older children (double and triple odds, respectively).
- After adjusting for confounding variables, newborns showed nearly a fivefold increase in survival odds, while infants maintained a significant survival advantage over older children.
Conclusions:
- Survival rates following pediatric ICU cardiac arrest are significantly dependent on patient age.
- Newborns and infants exhibit superior survival rates compared to older children, even after accounting for various confounding factors.
- These findings underscore the importance of age as a critical prognostic indicator in pediatric cardiac arrest management within intensive care settings.
Background:
Age is an important determinant of outcome from adult cardiac arrests but has not been identified previously as an important factor in pediatric cardiac arrests except among premature infants. Chest compressions can result in more effective blood flow during cardiac arrest in an infant than an older child or adult because of increased chest wall compliance. We, therefore, hypothesized that survival from cardiac arrest would be better among infants than older children.
Methods:
We evaluated 464 pediatric ICU arrests from the National Registry of Cardiopulmonary Resuscitation from 2000 to 2002. NICU cardiac arrests were excluded. Data from each arrest include >200 variables describing facility, patient, prearrest, arrest intervention, outcome, and quality improvement data. Age was categorized as newborn (<1 month; N = 62), infant (1 month to <1 year; N = 105), younger child (1 year to <8 years; N = 90), and older child (8 years to <21 years; N = 207). Multivariable logistic regression was performed to examine the association between age and survival.
Results:
Overall survival was 22%, with 27% of newborns, 36% of infants, 19% of younger children and 16% of older children surviving to hospital discharge. Newborns and infants demonstrated double and triple the odds of surviving to hospital discharge from a cardiac arrest in an intensive care setting when compared with older children. When potential confounders were controlled, newborns increased their advantage to almost fivefold, while infants maintained their survival advantage to older children.
Conclusions:
Survival from pediatric ICU cardiac arrest is age dependent. Newborns and infants have better survival rates even after adjusting for potential confounding variables.
Related Concept Videos
01:21Cardiopulmonary Resuscitation I: Adult
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:23Cardiopulmonary Resuscitation III: AED Use
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion