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Characterizing infections in children after out-of-hospital cardiac arrest

Stephanie L Cramer1, Kathleen Chiotos2, Maheswari Ekambaram3

  • 1Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.

Resuscitation
|July 11, 2026
PubMed

Insights

Bacterial infections are common in children after out-of-hospital cardiac arrest (OHCA) and linked to worse survival. Early identification and management of these infections are crucial for improving outcomes in pediatric OHCA patients.

Area of Science:

  • Pediatric critical care medicine
  • Infectious diseases
  • Cardiology

Background:

  • Infections can significantly impact morbidity and mortality in pediatric out-of-hospital cardiac arrest (OHCA).
  • Understanding the prevalence and impact of infections post-OHCA is vital for improving patient outcomes.

Purpose of the Study:

  • To determine the prevalence of infections in children following OHCA.
  • To investigate the association between bacterial infections and clinical characteristics and outcomes in pediatric OHCA survivors.

Main Methods:

  • A retrospective cohort study was conducted on children under 18 admitted to the pediatric intensive care unit (PICU) within 6 hours of OHCA.
  • Patients were categorized based on the presence of bacterial infections within 48 hours of admission using standardized criteria.
  • Logistic regression was employed to compare clinical characteristics and outcomes between infection groups.

Main Results:

  • A definite or probable bacterial infection was identified in 20% (40/203) of pediatric OHCA patients.
  • Children with bacterial infections experienced longer CPR durations and significantly lower survival rates to hospital discharge (33% vs. 70%).
  • Bacterial infection was independently associated with reduced odds of survival to hospital and ICU discharge, even after adjusting for key clinical factors.

Conclusions:

  • Bacterial infections are frequently observed in the early post-OHCA period in children and are associated with poorer clinical outcomes.
  • Further research is warranted to explore therapeutic strategies for OHCA-associated bacterial infections to enhance post-arrest recovery.
Abstract

Keywords:
Bacterial infectionsCardiopulmonary resuscitationPediatrics

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