Predictors of cardio pulmonary resuscitation outcome in postoperative cardiac children

Outcomes of cardiopulmonary resuscitation (CPR) in children with congenital heart disease have improved and many children have survived after an in-hospital cardiac arrest.

The purpose of this study is to determine predictors of poor outcome after CPR in critical children undergoing cardiac surgery.

We conducted a retrospective chart review and data analysis of all CPR records and charts of all postoperative cardiac children who had a cardiac arrest and required resuscitation from 2011 until 2015. Demographic, pre-operative, and postoperative data were reviewed and analyzed.

During the study period, 18 postoperative pediatric cardiac patients had CPR. Nine of them had return of spontaneous circulation and survived (50%). On average CPR was required on the 3(rd) postoperative day. Univariate analysis demonstrated that poor outcome was associated with higher lactic acid measured 4-6 hours prior to arrest (p = 0.045; p = 0.02) coupled with higher heart rate (p = 0.031), lower O2 saturation (p = 0.01), and lower core body temperature (p = 0.019) recorded 6 hours before arrest. Nonsurvival required longer resuscitation duration and more epinephrine doses (p < 0.05).

Higher heart rate, lower core body temperature, lower O2 saturation, and higher lactic acid measured 6 hours before arrest are possible predictors of poorer outcome and mortality following CPR in postoperative cardiac children.