[Multiple organ failure after spontaneous return of circulation in cardiac arrest in children]

Area of Science:

• Pediatric critical care medicine
• Cardiovascular research
• Pediatric emergency medicine

Background:

• In-hospital cardiac arrest (IHCA) in children carries a significant mortality risk.
• Assessing outcomes after return of spontaneous circulation (ROSC) is crucial for pediatric critical care.
• Understanding post-cardiac arrest complications like multiple organ failure (MOF) is vital for improving survival rates.

Purpose of the Study:

• To determine the incidence of multiple organ failure (MOF) in pediatric patients following IHCA and achieving ROSC.
• To evaluate the prognostic capability of MOF scores in predicting outcomes in this patient population.

Main Methods:

• A retrospective, single-center observational study included 41 children (1 month to 16 years) who experienced IHCA and achieved ROSC.
• Pediatric severity and MOF scores (PRISM, PIM II, PELOD, P-MODS) were recorded within 24-48 hours and again on day 5-7 post-ROSC.
• Clinical data, laboratory results, monitoring, treatment, mortality, and cause of death were analyzed.

Main Results:

• Overall mortality was 41.5%. Higher PRISM, PIM II, PELOD, and P-MODS scores were observed in non-survivors within 48 hours post-ROSC (P=.02 to P=.001).
• Between days 5-7 post-ROSC, higher PELOD (P=.002) and P-MODS (P=.003) scores in non-survivors indicated continued organ dysfunction.
• MOF scores demonstrated significant association with mortality in pediatric cardiac arrest survivors.

Conclusions:

• Mortality remains high for children experiencing IHCA and achieving ROSC.
• The development and severity of multiple organ failure post-ROSC are strongly associated with increased mortality in pediatric cardiac arrest survivors.