Pediatric Critical Care Medicine:

May 2014 - Volume 15 - Issue 4_suppl - p 126

doi: 10.1097/01.pcc.0000449279.69747.19

SURVIVAL AND NEUROLOGICAL OUTCOME FOLLOWING PEDIATRIC IN-HOSPITAL CARDIOPULMONARY RESUSCITATION IN CHANDIGARH

Rathore, V.; Bansal, A.; Singhi, S.C.; Singhi, P.; Jayashree, M.

ABSTRACT

Background and aims: Data on outcomes of children undergoing in-hospital cardiopulmonary resuscitation (CPR) are scarce form resource limited countries.

Aims: To describe clinical profile and outcomes of children undergoing in-hospital CPR.

Methods: This prospective observational study was carried out in Advance Pediatric Center, which is a part of academic institute in north India. All patients aged 1 month to 12 years who underwent in-hospital CPR from July 2010 through March 2011 were enrolled in this study. Data was recorded using the ‘Utstein style’. Outcome variables included ‘sustained return of spontaneous circulation’ (ROSC) for more than 20 min, survival at discharge and neurological outcome at 1 year as per Pediatric Cerebral Performance Category scale.

Results: The incidence of in-hospital CPR was 6.7% (n=314) of all hospital admission (n=4654). 64.6% (n=203) achieved sustained ROSC, 14 % (n=44) survived to hospital discharge and 11.1% (n=35) survived at 1 year. Three-fourth had good neurological outcome at 1 year follow up. Most of the CPR attempts took place in emergency unit (42%). Sepsis (71%), respiratory (39.5%), and neurological (31.5%) illness were the most common diagnosis in patients undergoing CPR. The most common initial rhythm was bradycardia (52.2%). On multivariate logistic regression duration of CPR, diagnosis of sepsis and requirement of vasoactive support prior to arrest were independent predictors of decreased hospital survival.

Conclusions: While ROSC was achieved in two third of children, subsequent mortality was higher in our cohort compared to western studies. However three fourth of survivors had good long term neurological outcome exemplifying the usefulness of timely CPR.