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Published in: Indian Journal of Pediatrics 11/2011

01-11-2011 | Original Article

Outcome of In-Hospital Pediatric Cardiopulmonary Arrest from a Single Center in Pakistan

Authors: Anwarul Haque, Arjumand Rizvi, Surraiya Bano

Published in: Indian Journal of Pediatrics | Issue 11/2011

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Abstract

Objective

To review the incidence and outcome of in-hospital pediatric cardiopulmonary arrest (CPA).

Methods

This retrospective six-year case series was carried out at the PICU and Pediatric Units of Aga Khan University Hospital (AKUH). All children aged 1 month to 14 years who underwent cardiopulmonary resuscitation from January 2001 through December 2006 were included. Data were recorded according to the Utstein style. The outcome variables were sustained return of spontaneous circulation (initial survival) and hospital discharge (final survival). Factors associated with survival were evaluated using logistic regression analysis.

Results

The incidence of CPA was 0.4% of all the admissions. Most of the CPR attempts took place in pediatric intensive care unit (53%) and the most frequent etiology was shock (78%). After initial CPR, the sustained return of spontaneous circulation was achieved in 58 patients (55%). Only 12 patients (11%) were discharged alive from the hospital. The most common initial documented rhythm was bradycardia (78%). Multivariate logistic regression analysis revealed that prolonged duration of CPR (>20 min) was the best predictor of initial and final mortality (p < 0.001).

Conclusions

The survival rate of in-hospital pediatric cardiopulmonary arrest in the present report is low.
Literature
1.
go back to reference Gillis JD, Rieder M, Steward D, et al. Results of inpatient pediatric resuscitation. Crit Care Med. 1986;14:469–71.PubMedCrossRef Gillis JD, Rieder M, Steward D, et al. Results of inpatient pediatric resuscitation. Crit Care Med. 1986;14:469–71.PubMedCrossRef
2.
3.
go back to reference Berg MD, Nadkarni VM, Berg RA. Cardiopulmonary resuscitation in children. Curr Opin Crit Care. 2008;14:254–60.PubMedCrossRef Berg MD, Nadkarni VM, Berg RA. Cardiopulmonary resuscitation in children. Curr Opin Crit Care. 2008;14:254–60.PubMedCrossRef
4.
go back to reference Nadkarni VM, Larkin GL, Peberdy MA, et al. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA. 2006;295:50–7.PubMedCrossRef Nadkarni VM, Larkin GL, Peberdy MA, et al. First documented rhythm and clinical outcome from in-hospital cardiac arrest among children and adults. JAMA. 2006;295:50–7.PubMedCrossRef
5.
go back to reference Tibballs J, Kinney S. A prospective study of outcome of in-patients pediatric cardiopulmonary arrest. Resuscitation. 2006;71:310–8.PubMedCrossRef Tibballs J, Kinney S. A prospective study of outcome of in-patients pediatric cardiopulmonary arrest. Resuscitation. 2006;71:310–8.PubMedCrossRef
6.
go back to reference Samson RA, Nadkarni VM, Meaney PA, et al. Outcomes of in-hospital ventricular fibrillation in children. N Engl J Med. 2006;354:2328.PubMedCrossRef Samson RA, Nadkarni VM, Meaney PA, et al. Outcomes of in-hospital ventricular fibrillation in children. N Engl J Med. 2006;354:2328.PubMedCrossRef
7.
go back to reference Suominen P, Olkkola KT, Voipa V, et al. Utstein style reporting of in-hospital pediatric cardiopulmonary resuscitation. Resuscitation. 2000;45:17–25.PubMedCrossRef Suominen P, Olkkola KT, Voipa V, et al. Utstein style reporting of in-hospital pediatric cardiopulmonary resuscitation. Resuscitation. 2000;45:17–25.PubMedCrossRef
8.
go back to reference Reis AG, Nadkarni VM, Perondi MB, et al. A prospective investigation into the epidemiology of in-hospital pediatric cardiopulmonary resuscitation using the international utstein reporting style. Pediatrics. 2002;109:200–9.PubMedCrossRef Reis AG, Nadkarni VM, Perondi MB, et al. A prospective investigation into the epidemiology of in-hospital pediatric cardiopulmonary resuscitation using the international utstein reporting style. Pediatrics. 2002;109:200–9.PubMedCrossRef
9.
go back to reference Guay J, Lortie L. An evaluation of pediatric in-hospital advanced life support interventions using the pediatric Utstein guidelines: a review of 203 cardiopulmonary arrests. Can J Anesth. 2004;51:373–8.PubMedCrossRef Guay J, Lortie L. An evaluation of pediatric in-hospital advanced life support interventions using the pediatric Utstein guidelines: a review of 203 cardiopulmonary arrests. Can J Anesth. 2004;51:373–8.PubMedCrossRef
10.
go back to reference American Heart Association (AHA) in Collaboration with the International Liaison Committee on Resuscitation (ILCOR). Guidelines 2005 for cardiopulmonary resuscitation and emergency cardiovascular care, pediatric advanced life support and pediatric basic life support. Circulation. 2005;112:I67–87.CrossRef American Heart Association (AHA) in Collaboration with the International Liaison Committee on Resuscitation (ILCOR). Guidelines 2005 for cardiopulmonary resuscitation and emergency cardiovascular care, pediatric advanced life support and pediatric basic life support. Circulation. 2005;112:I67–87.CrossRef
11.
go back to reference Berg MD, Nadkarni VM, Zuercher M, et al. In-hospital pediatric cardiac arrest. Pediatr Clin N Am. 2008;55:589–604.CrossRef Berg MD, Nadkarni VM, Zuercher M, et al. In-hospital pediatric cardiac arrest. Pediatr Clin N Am. 2008;55:589–604.CrossRef
12.
go back to reference Zaritsky A, Nadkarni V, Hazinski MF, et al. Recommended guidelines for uniform reporting of pediatric advance life support: the pediatric Utstein Style. Pediatrics. 1995;96:765–79.PubMed Zaritsky A, Nadkarni V, Hazinski MF, et al. Recommended guidelines for uniform reporting of pediatric advance life support: the pediatric Utstein Style. Pediatrics. 1995;96:765–79.PubMed
13.
go back to reference Sharek PJ, Parast LM, Leong K, et al. Effect of a rapid response team on hospital-wide mortality and code rates outside the ICU in a children’s hospital. JAMA. 2007;298:2267–74.PubMedCrossRef Sharek PJ, Parast LM, Leong K, et al. Effect of a rapid response team on hospital-wide mortality and code rates outside the ICU in a children’s hospital. JAMA. 2007;298:2267–74.PubMedCrossRef
14.
go back to reference Gallagher EJ, Lombardi G, Gennis P. Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest. JAMA. 1995;274:1922–5.PubMedCrossRef Gallagher EJ, Lombardi G, Gennis P. Effectiveness of bystander cardiopulmonary resuscitation and survival following out-of-hospital cardiac arrest. JAMA. 1995;274:1922–5.PubMedCrossRef
15.
go back to reference Haque A, Ali FS, Zaidi S, et al. Experience of pediatric rapid response team in a tertiary care hospital in Pakistan. Indian J Pediatr. 2010;77:273–6.CrossRef Haque A, Ali FS, Zaidi S, et al. Experience of pediatric rapid response team in a tertiary care hospital in Pakistan. Indian J Pediatr. 2010;77:273–6.CrossRef
16.
go back to reference Adrie C, Adib-Conquy M, Laurent I, et al. Successful cardiopulmonary resuscitation after cardiac arrest as a “Sepsis-like” Syndrome. Circulation. 2002;106:562–8.PubMedCrossRef Adrie C, Adib-Conquy M, Laurent I, et al. Successful cardiopulmonary resuscitation after cardiac arrest as a “Sepsis-like” Syndrome. Circulation. 2002;106:562–8.PubMedCrossRef
17.
go back to reference Kleinman ME, Srinivasan V. Post-resuscitation care. Pediatr Clin N Am. 2008;55:943–67.CrossRef Kleinman ME, Srinivasan V. Post-resuscitation care. Pediatr Clin N Am. 2008;55:943–67.CrossRef
18.
go back to reference Sunde K, Pylte M, Jacobsen D, et al. Implementation of a standardized treatment protocol for post resuscitation care after out-of-hospital cardiac arrest. Resuscitation. 2007;73:29–39.PubMedCrossRef Sunde K, Pylte M, Jacobsen D, et al. Implementation of a standardized treatment protocol for post resuscitation care after out-of-hospital cardiac arrest. Resuscitation. 2007;73:29–39.PubMedCrossRef
19.
go back to reference Peberdy MA, Ornato JP. Post Resuscitation care: is it the missing link in the chain of survival? Resuscitation. 2005;64:135–7.PubMedCrossRef Peberdy MA, Ornato JP. Post Resuscitation care: is it the missing link in the chain of survival? Resuscitation. 2005;64:135–7.PubMedCrossRef
Metadata
Title
Outcome of In-Hospital Pediatric Cardiopulmonary Arrest from a Single Center in Pakistan
Authors
Anwarul Haque
Arjumand Rizvi
Surraiya Bano
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Indian Journal of Pediatrics / Issue 11/2011
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI
https://doi.org/10.1007/s12098-011-0439-4

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