Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study

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Jimena Del Castillo1, Jesús López-Herce1, Martha Matamoros2

  • 1Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón de Madrid, Medicine School, Complutense University of Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, Spain.

Resuscitation
|August 23, 2015
PubMed

Insights

One year after pediatric in-hospital cardiac arrest (CA), survival is high, with most children maintaining their neurologic status. Traumatic or neurologic illness and high lactic acid levels post-resuscitation are linked to poorer long-term outcomes.

Area of Science:

  • Pediatric Critical Care Medicine
  • Pediatric Cardiology
  • Neurology

Background:

  • In-hospital pediatric cardiac arrest (CA) presents significant survival and long-term neurologic challenges.
  • Understanding risk factors is crucial for improving outcomes in pediatric CA survivors.

Purpose of the Study:

  • To assess the survival rates and neurologic evolution of children experiencing in-hospital CA.
  • To identify risk factors influencing the long-term neurologic outcome after pediatric CA.

Main Methods:

  • A prospective, international, observational, multicenter study involving 48 hospitals across 12 countries.
  • Analysis of pediatric CA cases (1 month to 18 years) using the Utstein template.
  • Evaluation of survival and neurologic status (Pediatric Cerebral Performance Category scale) one year post-discharge.

Main Results:

  • Out of 502 pediatric CA patients, 39.2% survived to discharge. Among survivors, 76.9% had good neurologic function (PCPC 1-2) at discharge.
  • One year post-arrest, 75.9% of evaluated patients maintained good neurologic function.
  • Neurologic deterioration was observed in 7.9% of patients, with outcomes largely stable compared to hospital discharge.

Conclusions:

  • One-year survival after pediatric in-hospital CA is substantial, with stable neurologic outcomes for most survivors.
  • Factors associated with worse long-term neurologic outcomes include traumatic/neurologic etiology and persistent high lactate levels 24h post-ROSC.
  • Standardized protocols, adaptable for resource-limited settings, are recommended for future multicenter studies.
Abstract

Keywords:
Cardiac arrestChildrenIn-hospital cardiac arrestLong-term outcomeResuscitation

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