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In-hospital pediatric cardiac arrest in Spain
Jesús López-Herce1, Jimena del Castillo1, Sonia Cañadas2
1Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Insights
Survival rates for pediatric cardiac arrest in Spain have significantly improved, with 41% of children surviving hospital discharge. Key factors influencing mortality include underlying diseases, continuous vasoactive drug infusions, and prolonged resuscitation efforts.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiology
- Emergency Medicine
Background:
- In-hospital pediatric cardiac arrest (IHCA) remains a critical concern.
- Previous studies indicated lower survival rates in Spain.
Purpose of the Study:
- To analyze the characteristics of IHCA in Spanish children.
- To identify prognostic factors associated with mortality.
Main Methods:
- Prospective observational study involving 200 children (1 month to 18 years) experiencing IHCA.
- Univariate and multivariate logistic regression analyses were used to determine mortality predictors.
Main Results:
- A survival rate of 41% to hospital discharge was observed, a significant increase from previous studies.
- Factors associated with mortality included hematologic/oncologic diseases, continuous vasoactive drug infusion, prolonged cardiopulmonary resuscitation (>20 min), and treatment with bicarbonate and volume expansion.
Conclusions:
- Survival following IHCA in children has markedly improved in Spain.
- Hematologic/oncologic diseases, pre-arrest vasoactive drug infusion, resuscitation duration, and specific treatments are key factors influencing in-hospital mortality.
Introduction And Objectives:
The objective was to analyze the characteristics and prognostic factors of in-hospital pediatric cardiac arrest in Spain.
Methods:
A prospective observational study was performed to examine in-hospital pediatric cardiac arrest. Two hundred children were studied, aged between 1 month and 18 years, with in-hospital cardiac arrest. Univariate and multivariate logistic regression analyses were performed to assess the influence of each factor on survival to hospital discharge.
Results:
Return of spontaneous circulation was achieved in 74% of the patients and 41% survived to hospital discharge. The survival rate was significantly higher than that reported in a previous Spanish study 10 years earlier (25.9%). In the univariate analysis, the factors related to mortality were body weight higher than 10 kg; continuous infusion of vasoactive drugs prior to cardiac arrest; sepsis and neurological disorders as causes of cardiac arrest, the need for treatment with adrenaline, bicarbonate, and volume expansion, and prolonged cardiopulmonary resuscitation. In the multivariate analysis, the factors related to mortality were hematologic/oncologic diseases, continuous infusion of vasoactive drugs prior to cardiac arrest, cardiopulmonary resuscitation for more than 20 min, and treatment with bicarbonate and volume expansion.
Conclusions:
Survival after in-hospital cardiac arrest in children has significantly improved in recent years. The factors related to in-hospital mortality were hematologic/oncologic diseases, continuous infusion of vasoactive drugs prior to cardiac arrest, the duration of cardiopulmonary resuscitation, and treatment with bicarbonate and volume expansion.
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