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Outcomes of Cardiopulmonary Resuscitation in the Pediatric Intensive Care of a Tertiary Center

Ayman Al-Eyadhy1,2, Mohammed Almazyad1,2, Gamal Hasan2,3,4

  • 1Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Journal of Pediatric Intensive Care
|November 16, 2023
PubMed

Insights

Cardiopulmonary resuscitation (CPR) in a pediatric intensive care unit (PICU) showed a 32.3% survival to discharge rate. Shorter CPR duration and younger age were linked to better outcomes, highlighting duration as a key factor.

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiopulmonary Resuscitation (CPR)
  • Clinical Outcomes Research

Background:

  • Optimizing patient outcomes after cardiopulmonary resuscitation (CPR) requires understanding survival factors and addressing preventable causes.
  • Cardiac arrest and CPR events are critical in pediatric intensive care units (PICUs), necessitating detailed outcome analysis.

Purpose of the Study:

  • To determine the prevalence and outcomes of cardiac arrest and CPR in a tertiary pediatric intensive care unit (PICU).
  • To identify factors associated with return of spontaneous circulation (ROSC), 24-hour survival, and hospital discharge survival post-CPR.

Main Methods:

  • Retrospective analysis of the PICU CPR registry from January 1, 2011, to January 1, 2018.
  • Inclusion criteria: Patients undergoing at least 2 minutes of CPR.
  • Outcomes assessed: ROSC > 20 minutes, 24-hour survival, and survival to hospital discharge.

Main Results:

  • CPR occurred in 65 instances (1.85% prevalence) among pediatric patients (mean age 32.7 months).
  • Return of spontaneous circulation (ROSC) was achieved in 58.5%, 24-hour survival in 46.2%, and hospital discharge survival in 32.3%.
  • Factors associated with better outcomes included younger age, respiratory cause, bradycardia, and shorter CPR duration. Certain medications (sodium bicarbonate, norepinephrine, vasopressin) were linked to worse outcomes. CPR duration negatively impacted survival by 8.7% per minute.

Conclusions:

  • CPR duration is a critical determinant of patient outcomes, emphasizing its importance alongside CPR quality guidelines.
  • The survival rate post-ROSC warrants careful consideration for parental counseling.
  • Preventing CPR events remains a significant ongoing challenge in pediatric intensive care.

Keywords:
Saudicardiopulmonary resuscitationpediatricpediatric intensive care unitsurvival

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