Cardiac arrest-pdf file

Neurological outcome was assessed using the as having a comorbidity if they had a pre-existing illness Paediatric Cerebral Performance Category PCPC scale. The PCPC clinical, radiological, pathology and coroner reports, were score was determined from a retrospective review of assigned: asphyxia, respiratory, neurological, submersion, discharge and outpatient notes.

Children Continuous variables are presented as medians with were also further classified as having an OHCA of either interquartile ranges IQRs , and categorical variables as cardiac or non-cardiac aetiology if the arrest was caused by frequencies and percentages.

Continuous variables were a primary cardiac event including dysrhythmias, congenital compared using the Kruskal—Wallis test, and categorical heart disease and myocarditis. Study characteristics were compared Event characteristics between the four initial rhythm types sinus rhythm, Event characteristic data collected included witnessed arrest shockable rhythm, PEA and asystole.

Model 1 monitored cardiac rhythm initial rhythm , total duration checked the association between pre-hospital variables and of CPR bystander and EMS CPR , and administration of the primary outcome. The following variables were used in epinephrine and return of spontaneous circulation before the model: age, sex, bystander CPR, and CPR duration.

The hospital arrival. The initial rhythm, as documented in the cardiac and submersion aetiological categories were also EMS notes, was categorised by EMS personnel as sinus included in Model 1, because of previous evidence indicating rhythm, shockable rhythm pulseless ventricular tachycardia superior outcomes.

Age was categorised on arrival or died in the ED Figure 2 Appendix 3. Initial cardiac rhythm was not available The final multivariable model was created by a stepwise for three children, so they were excluded from our analyses.

If a high correlation was identified, the variable of least clinical importance was Figure 2. Overview of out-of-hospital cardiac arrest dropped from the multivariable model.

Because admission SBP, lactate level, pupillary responses and VIS score at admission 0 hours were highly correlated with PIM2 score, they were not included in the model.

Goodness-of-fit of the final model was assessed using the Hosmer—Lemeshow statistic. All analyses were performed using Stata, version Of the presentations, 16 children were excluded as electrical activity.

Two children had SIDS as asystole had a median lactate level of 8. This was highest for children Table 1. Table 2. Table 4. Hospital survival with Factors associated with primary outcome unfavourable neurological outcome Table 6 shows the multivariable logistic regression models Severe disability 5 3 2 for factors associated with survival with a favourable Coma or vegetative state 2 2 0 neurological outcome.

Other factors associated with was Model 2 Our results showed that children with OHCA of cardiac looked at hospital and intensive care factors from the time v non-cardiac aetiology were more likely to survive with of admission and their association with survival with a favourable neurological outcome.

Akahane and colleagues favourable neurological outcome. The associations were: reported that junior high school children were more likely 4-hour post-admission VIS, 1— Our results also showed that outcome.

This is consistent with animal rescue breathing or compression-only CPR is effective for studies,20 epidemiological evidence of adult OHCA21,22 and children with sudden OHCA caused by a primary cardiac previous studies in children. A previous to witness an OHCA, which includes families with children, community study from Melbourne, however, did not show particularly families with swimming pools and with children an association between bystander CPR and outcome.

This with pre-existing disease conditions and comorbidities. There have therefore been several societal and in the current PICU cohort.

However, even after controlling for cardiac pool fencing requirements,32 that may have altered trends and submersion aetiology, bystander CPR had a strong in paediatric OHCA. It also remains to be seen whether association with survival with favourable neurological the increasing prevalence of children living with chronic outcome among the OHCA cohort in the PICU. This information may studies. The reasons for the association between males and present important public health and clinical information to negative outcome are not entirely clear and are beyond the guide future planning for children presenting with OHCA, scope of this study, but it is important to note that boys and is therefore an area for future research.

Biological and other environmental factors may Study limitations also be involved in this association. First, we did not capture all children admitted negative predictor of survival with a favourable neurological to the PICU after OHCA in Victoria, as some children may outcome. However, we recognise that, because the RCH is the largest specialist Study implications and future directions paediatric hospital in Victoria, most children are transferred The impact of bystander CPR on survival with a favourable there, which will have minimised this potential limitation.

In Victoria over the past decade, available in the data sources. We also did not defibrillators has increased fold. Despite this, core Utstein community. VIC, Australia. Finally, the utility of the PCPC score was limited, as it may not 2 Department of Paediatrics, University of Melbourne, have reflected subtle changes in cognitive function.

Out-of-hospital a more age-appropriate and extensive neurobehavioural pediatric cardiac arrest: an epidemiologic review and assessment tool would have been optimal, but the PCPC assessment of current knowledge. Ann Emerg Med ; score nonetheless provided a quick way of identifying a Improving outcomes from out-of-hospital cardiac arrest in young children and adolescents.

Pediatr Cardiol ; Epidemiology of This observational study of children admitted to the PICU paediatric out-of-hospital cardiac arrest in Melbourne, Australia.

Resuscitation ; Epidemiology with a favourable neurological outcome. Circulation ; Pediatric out-of-hospital with a non-cardiac aetiology. Receiving bystander CPR cardiac arrest in Korea: a nationwide population-based study. Trends in PICU awareness of and education and training for CPR for the admission and survival rates in children in Australia and New community in general, and particularly targeting people Zealand following cardiac arrest.

Report of the to present important public health and clinical information Australian and New Zealand Paediatric Intensive Care Registry to guide future management of these children. Pediatrics ; e Basic and advanced Duke for useful suggestions.

We also thank Carmel Delzoppo paediatric cardiopulmonary resuscitation — guidelines of the and Jenny Thompson for supplying information and contributing Australian and New Zealand Resuscitation Councils J to the PICU database. Survival trends in pediatric possible. Circ Cardiovasc Qual Outcomes ; 6: A quantitative analysis of None declared. Intensive care. Open navigation menu. Close suggestions Search Search. User Settings. Skip carousel. Carousel Previous. Carousel Next.

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