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Al-Eyadhy A, Almazyad M, Hasan G, AlKhudhayri N, AlSaeed AF, Habib M, Alhaboob AAN, AlAyed M, AlSehibani Y, Alsohime F, Alabdulhafid M, Temsah MH. Outcomes of Cardiopulmonary Resuscitation in the Pediatric Intensive Care of a Tertiary Center. J Pediatr Intensive Care 2023; 12:303-311. [PMID: 37970137 PMCID: PMC10631842 DOI: 10.1055/s-0041-1733855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/04/2021] [Indexed: 10/20/2022] Open
Abstract
Understanding the factors affecting survival and modifying the preventable factors may improve patient outcomes following cardiopulmonary resuscitation (CPR). The aim of this study was to assess the prevalence and outcomes of cardiac arrest and CPR events in a tertiary pediatric intensive care unit (PICU). Outcomes of interest were the return of spontaneous circulation (ROSC) lasting more than 20 minutes, survival for 24 hours post-CPR, and survival to hospital discharge. We analyzed data from the PICU CPR registry from January 1, 2011 to January 1, 2018. All patients who underwent at least 2 minutes of CPR in the PICU were included. CPR was administered in 65 PICU instances, with a prevalence of 1.85%. The mean patient age was 32.7 months. ROSC occurred in 38 (58.5%) patients, 30 (46.2%) achieved 24-hour survival, and 21 (32.3%) survived to hospital discharge. Younger age ( p < 0.018), respiratory cause ( p < 0.001), bradycardia ( p < 0.018), and short duration of CPR ( p < 0.001) were associated with better outcomes, while sodium bicarbonate, norepinephrine, and vasopressin were associated with worse outcome ( p < 0.009). The off-hour CPR had no impact on the outcome. The patients' cumulative predicted survival declined by an average of 8.7% for an additional 1 minute duration of CPR ( p = 0.001). The study concludes that the duration of CPR, therefore, remains one of the crucial factors determining CPR outcomes and needs to be considered in parallel with the guideline emphasis on CPR quality. The lower survival rate post-ROSC needs careful consideration during parental counseling. Better anticipation and prevention of CPR remain ongoing challenges.
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Affiliation(s)
- Ayman Al-Eyadhy
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Almazyad
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Gamal Hasan
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Assiut Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Pediatrics, Pediatric Critical Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | | | | | - Mohammed Habib
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ali A. N. Alhaboob
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed AlAyed
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Fahad Alsohime
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Majed Alabdulhafid
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
| | - Mohamad-Hani Temsah
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Department of Pediatrics, Pediatric Intensive Care Unit, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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