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The association between initial post-resuscitation diastolic blood pressure and survival after pediatric cardiac
Min Kyo Chun1, Jun Sung Park1, Jeeho Han1
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Insights
Post-resuscitation diastolic blood pressure (DBP) is a key predictor of survival in pediatric patients after cardiopulmonary resuscitation (CPR). Higher DBP within one hour of return of spontaneous circulation (ROSC) is associated with better outcomes.
Area of Science:
- Pediatric critical care medicine
- Cardiovascular physiology
- Emergency medicine
Background:
- Limited research exists on the link between diastolic blood pressure (DBP) and survival post-pediatric cardiopulmonary resuscitation (CPR).
- Understanding prognostic factors after pediatric CPR is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the association between post-resuscitation diastolic blood pressure (DBP) and survival in pediatric patients who underwent CPR.
- To identify potential prognostic markers for survival following pediatric CPR.
Main Methods:
- Retrospective single-center study of pediatric patients in a pediatric intensive care unit (PICU).
- Included patients admitted between January 2016 and November 2022.
- Excluded patients undergoing extracorporeal CPR or with unavailable data; primary endpoint was survival to ICU discharge.
Main Results:
- 106 pediatric patients were analyzed, with a 63.2% survival rate to ICU discharge.
- Diastolic blood pressure (DBP) within 1 hour after return of spontaneous circulation (ROSC) was the sole significant predictor of survival (aOR, 1.043; p=0.002).
- DBP within 1 hour post-ROSC showed an area under the ROC curve of 0.7 for predicting survival.
Conclusions:
- Post-resuscitation diastolic blood pressure (DBP) within 1 hour of ROSC is a significant prognostic factor for survival in pediatric patients.
- Further prospective, large-scale studies are needed to confirm optimal post-resuscitation DBP targets for pediatric patients.
Background:
Limited research has analyzed the association between diastolic blood pressure (DBP) and survival after pediatric cardiopulmonary resuscitation (CPR). This study aimed to explore the association between post-resuscitation diastolic blood pressure and survival in pediatric patients who underwent CPR.
Method:
This retrospective single-center study included pediatric patients admitted to the pediatric intensive care unit of Asan Medical Center between January 2016 to November 2022. Patients undergoing extracorporeal CPR and those with unavailable data were excluded. The primary endpoint was survival to ICU discharge.
Results:
A total of 106 patients were included, with 67 (63.2%) achieving survival to ICU discharge. Multivariate logistic regression analysis identified DBP within 1 h after ROSC as the sole significant variable (p = 0.002, aOR, 1.043; 95% CI, 1.016-1.070). Additionally, DBP within 1 h demonstrated an area under the ROC curve of 0.7 (0.592-0.809) for survival to ICU discharge, along with mean blood pressure within the same timeframe.
Conclusion:
Our study highlights the importance of DBP within 1-hour post-ROSC as a significant prognostic factor for survival to ICU discharge. However, further validation through further prospective large-scale studies is warranted to confirm the appropriate post-resuscitation DBP of pediatric patients.
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