Outcome of cardiopulmonary resuscitation in the neonatal intensive care unit

Area of Science:

• Neonatal Medicine
• Pediatric Critical Care
• Resuscitation Science

Background:

• Cardiopulmonary resuscitation (CPR) is a critical intervention for critically ill neonates.
• Understanding long-term outcomes following neonatal CPR is essential for clinical practice and parental counseling.
• Existing data on neonatal CPR survival and neurological outcomes remain limited.

Purpose of the Study:

• To evaluate the survival rates and neurological outcomes of infants who underwent CPR in a neonatal intensive care unit (NICU).
• To identify factors associated with both favorable and unfavorable outcomes after neonatal CPR.
• To compare neonatal CPR outcomes with available adult data.

Main Methods:

• Retrospective review of 83 infants who received CPR in a teaching hospital's NICU.
• Analysis of patient data including demographics, clinical course, interventions, and outcomes.
• Statistical analysis to identify factors significantly associated with survival and neurological status.

Main Results:

• 14% (12/83) of infants were discharged from the hospital; 8% (7/83) survived for at least 1 year post-discharge, with 5 appearing neurologically intact.
• 41% (12/29) of patients surviving at least 24 hours post-CPR were discharged alive.
• Factors associated with poor outcomes included sepsis, oliguria, prematurity, and intraventricular hemorrhage (IVH).
• Factors associated with good outcomes included intubation during resuscitation and major congenital anomalies.
• IVH was the strongest predictor of poor outcome in regression analysis.

Conclusions:

• Neonatal CPR survival and long-term outcomes are comparable to adult data.
• Intraventricular hemorrhage is a critical factor negatively impacting survival and neurological status.
• Early identification of prognostic factors can aid in managing expectations and guiding care for neonates undergoing CPR.