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Updated: Oct 3, 2025

A Piglet Perinatal Asphyxia Model to Study Cardiac Injury and Hemodynamics after Cardiac Arrest, Resuscitation, and the Return of Spontaneous Circulation
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Pulseless electrical activity and asystolic cardiac arrest in infants: identifying factors that influence outcomes

Kathryn Best1, Myra H Wyckoff2, Rong Huang3

  • 1UT Southwestern Medical Center Department of Pediatrics Division of Critical Care Medicine, Dallas, TX, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|February 18, 2022
PubMed

Insights

Pulseless electrical activity (PEA) and asystolic cardiac arrest (CA) are uncommon in infants. Poor outcomes are linked to inotrope support and prolonged resuscitation efforts.

Area of Science:

  • Pediatric Critical Care
  • Neonatal Resuscitation
  • Cardiology

Background:

  • Limited data exists on pulseless electrical activity (PEA) or asystolic cardiac arrest (CA) in infants.
  • Understanding incidence and outcomes is crucial for this population.

Purpose of the Study:

  • To describe the incidence of PEA/asystolic CA in infants.
  • To identify factors associated with outcomes in infants experiencing PEA/asystolic CA.

Main Methods:

  • Single-center retrospective chart review.
  • Study included infants (<1 year) with in-hospital PEA/asystolic CA from 2011-2019.
  • Primary outcome: return of spontaneous circulation (ROSC); Secondary outcome: survival to discharge.

Main Results:

  • PEA/asystolic CA occurred in 38 of 148 infants (26%).
  • ROSC was achieved in 76% (29/38) and survival to discharge in 32% (12/38).
  • Inotrope support, longer chest compressions, and epinephrine administration were associated with increased mortality. Respiratory etiology predicted survival.

Conclusions:

  • PEA/asystolic cardiac arrests are infrequent in infants.
  • Pre-arrest inotropic support and prolonged chest compressions are poor prognostic indicators.
Abstract

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