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Patterns of multiorgan dysfunction after pediatric drowning.

Haifa Mtaweh1, Patrick M Kochanek2, Joseph A Carcillo3

  • 1Critical Care Department, The Hospital for Sick Children, Toronto, Canada; Safar Center for Resuscitation Research, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States.

Resuscitation
|February 24, 2015
PubMed
Summary
This summary is machine-generated.

Children with cardiorespiratory arrest after drowning had multiorgan failure and poor neurologic outcomes. Respiratory arrest in pediatric drowning patients showed different organ failure patterns and better outcomes.

Keywords:
ArrestChildrenDrowningMultiorgan failureNeurologic outcomeOrgan dysfunction

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Area of Science:

  • Pediatric critical care medicine
  • Drowning research
  • Neurology

Background:

  • Drowning is a leading cause of pediatric injury death.
  • Multiorgan dysfunction and neurologic outcomes are critical in pediatric drowning survivors.
  • Understanding differences between respiratory and cardiac arrest in drowning is essential for targeted interventions.

Purpose of the Study:

  • To evaluate multiorgan dysfunction patterns in pediatric drowning patients.
  • To assess neurologic outcomes in children experiencing respiratory versus cardiac arrest post-drowning.
  • To identify differences in organ failure between respiratory arrest and cardiorespiratory arrest in pediatric drowning.

Main Methods:

  • Retrospective chart review of pediatric patients (0-21 years) with drowning.
  • Analysis of organ dysfunction using Pediatric Logistic Organ Dysfunction Score-1 (PELOD-1) and Pediatric Multiple Organ Dysfunction Score (P-MODS) within 24 hours.
  • Neurologic outcome assessment using Pediatric Cerebral and Overall Performance Category Scale at discharge.

Main Results:

  • Children with cardiorespiratory arrest (CA) had higher rates of multiorgan failure and poor neurologic outcomes (81%) compared to those with respiratory arrest (RA) (49%).
  • Respiratory arrest patients had significantly better neurologic outcomes (p<0.001).
  • Common organ failures included respiratory, neurologic, and cardiovascular in both groups, with variations in frequency.

Conclusions:

  • Organ failure patterns significantly differ between cardiorespiratory arrest and respiratory arrest in pediatric drowning.
  • Multiorgan failure is a key contributor to poor outcomes in pediatric drowning.
  • Further research into MOF-targeting therapies to augment cerebral resuscitation in drowning is warranted.