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[Results of cardiopulmonary resuscitation in children]
H Stopfkuchen1, G Stein, A Queisser-Luft
1Universitätskinderklinik Mainz.
Insights
Cardiopulmonary resuscitation (CPR) in children has a poor survival rate, with only 20.8% surviving to discharge. Pediatric Intensive Care Unit arrests had the worst outcomes, while out-of-hospital arrests showed better results.
Area of Science:
- Pediatric critical care medicine
- Emergency medicine
- Resuscitation science
Context:
- Cardiopulmonary arrest (CPA) is a critical event in pediatric care.
- Outcomes of cardiopulmonary resuscitation (CPR) in children are variable and often poor.
- Understanding factors influencing pediatric CPR survival is crucial for improving patient care.
Purpose:
- To retrospectively evaluate the outcomes of cardiopulmonary resuscitation (CPR) in a large cohort of pediatric patients.
- To identify factors associated with survival and mortality following pediatric CPR.
- To analyze the impact of arrest location on CPR outcomes in children.
Summary:
- This study analyzed 149 pediatric CPR cases, revealing a 20.8% survival rate to discharge.
- Mortality was high, with 31.5% immediate deaths and 32.2% deaths within 24 hours.
- Pediatric Intensive Care Unit arrests had the worst prognosis, contrasting with better outcomes in out-of-hospital settings, the operating room, or the pediatric floor.
- Survival did not correlate with age or catecholamine type, and calcium administration was associated with non-survival.
- Five survivors experienced severe neurologic sequelae.
Impact:
- This study confirms the generally poor outcomes associated with pediatric CPR.
- Findings highlight the need for improved strategies and interventions for pediatric resuscitation.
- Identifying high-risk settings like the PICU can guide targeted quality improvement initiatives.
Abstract:
We retrospectively evaluated the outcome from cardiopulmonary resuscitation (CPR) in 149 children of all age groups. Only 7 children experienced ventricular fibrillation. 47 children (31.5%) died immediately. Further 47 children died within 24 hours of their arrest, 24 (16.1%) survived longer than 24 hours after CPR but not until discharge. Only 31 children (20.8%) survived to discharge, 5 with severe neurologic sequelae, attributable to the arrest or resuscitation efforts. Cardiopulmonary arrests in the Pediatric Intensive Care Unit carried the worst prognosis. Better results were obtained out-of-hospital, in the OR or on the pediatric floor. Long-term survival rate did not correlate with age, or type of administered catecholamine. None of the children receiving calcium survived. This large study confirms the poor outcome of CPR in children.