Probability of survival based on etiology of cardiopulmonary arrest in pediatric patients

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Richard J Berens1, Laura D Cassidy, Jennifer Matchey

  • 1Medical College of Wisconsin, Milwaukee WI, USA. RBerens@chw.org

Paediatric Anaesthesia
|January 5, 2011
PubMed

Insights

Survival probability after pediatric cardiac arrest differs significantly based on the cause. Respiratory-induced arrests have a higher initial survival chance, but this dramatically decreases with prolonged cardiopulmonary resuscitation (CPR).

Area of Science:

  • Pediatric critical care medicine
  • Cardiology
  • Resuscitation science

Background:

  • In-hospital cardiac arrests affect 2-6% of pediatric patients.
  • Poor survival rates lead to significant resource utilization.

Purpose of the Study:

  • To aggregate multi-institutional data to identify predictors of survival in pediatric cardiac arrest.
  • To evaluate the association between cardiopulmonary resuscitation (CPR) duration and survival probability, stratified by arrest etiology.

Main Methods:

  • Retrospective analysis of 257 pediatric patients from six hospitals who experienced pulseless cardiac arrest and received CPR.
  • Data included demographics, arrest details, treatments, CPR duration, and outcomes.
  • Logistic regression was used to generate survival probability curves stratified by cardiac-induced cardiac arrest (CICA) and respiratory-induced cardiac arrest (RICA).

Main Results:

  • Overall survival to discharge was 27% for CICA and 35% for RICA.
  • Initial survival probability (Ps) at 1 minute of CPR was 29% for CICA and 62% for RICA.
  • For RICA, Ps dropped dramatically to 0.2% at 60 minutes, while CICA Ps remained relatively constant at 25%.

Conclusions:

  • Survival probability curves based on CPR duration significantly differ between CICA and RICA patients.
  • The etiology of pediatric cardiac arrest is a critical factor in determining survival outcomes, especially concerning CPR duration.
Abstract

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