Objective To study the characteristics of cardiac arrest (CA) and the results of resuscitation in pediatric intensive care units (PICU).
Patients and methods: Prospective, international, multicentrical study. Children between 1 month and 18 years who suffered CA in the PICU were included. Sustained return of spontaneous circulation (ROSC) and survival at hospital discharge were analyzed.
Results 304 CA episodes in 250 patients were registered, 96 (31.6%) in latinoamerican and 208 (68.4%) in European hospitals. Mean age was 47.9 months, mean weight 16.4 kg and 55.6% males. The most common causes of CA were cardiac (35.9%), respiratory (31.6%) and sepsis (15.3%). ROSC was attained in 68.1% of the cases but only 40.4% survived. ROSC was higher in European 75.9% than in Latinamerican 55.4% PICUs (p=0.001). Patients with good neurological scales before CA (PCPC <=2) had significantly higher ROSC rates (74.5% vs 33.3%; p=0.006). Patients who had suffered a previous CA had lower ROSC percentages (51.7% vs 71.1%; p=0.03). Respiratory and cardiac CA have higher survival rates (40% and 56.3%) than sepsis (13.5%), and neurologic and traumatic causes (31.7%) (p<0.001). Initial respiratory arrests achieved higher survival rates than primary CA (49% vs 35.1%; p=0.029). Patients previously receiving inotropic drugs survived less than those who received no medication (31.3% vs 58%; p<0.001).
Conclusions Although 68% of patients who suffered a CA attained ROSC only 40% of them survived. Ethiology of CA, type of initial arrest and previous treatment with inotropics influence survival in PICU cardiac arrest.
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