Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study |
| |
| Affiliation: | 1. Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria del Hospital Gregorio Marañón de Madrid, Medicine School, Complutense University of Madrid, Red de Salud Maternoinfantil y del Desarrollo (Red SAMID), Madrid, Spain;2. Pediatric Intensive Care Unit. Hospital Escuela, Tegucigalpa, Honduras;3. Pediatric Intensive Care Unit. Hospital Valle de Hebroón, Barcelona, Spain;4. Pediatric Intensive Care Unit, Hospital Niño Jesús, Tucumán, Argentina;5. Pediatric Intensive Care Unit. Ospedale Bambinu Gesu, Roma, Italy;6. Pediatric Intensive Care Department. Hospital Clínico Universitario. Santiago de Compostela. Spain;1. Max-Planck-Institut für Kernphysik, Postfach 103980, D-69029 Heidelberg, Germany;2. Institute of Modern Physics and Center for High Energy Physics, Tsinghua University, Beijing 100084, China;1. Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita 565-0871, Japan;2. Department of Food Science, Otsuma Women’s University, 12 Sanbancho Chiyoda-ku, Tokyo 102-8357, Japan;3. Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamada-Oka, Suita 565-0871, Japan;4. Department of Emergency Medicine, Hyogo Prefectural Kobe Children’s Hospital, 1-6-7 Minatojima Chuo-ku, Kobe 650-0047, Japan;5. Department of Pediatrics, Nihon University School of Medicine, 30-1 Ooyaguchikamichou, Itabashi-ku, Tokyo 173-8610, Japan;6. Department of Emergency Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan;7. Department of Pediatrics, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan;8. Kyoto University Health Service, Yoshida Honmachi, Sakyo-ku, Kyoto 606-8501, Japan;1. Department of Food Science, Faculty of Home Economics, Otsuma Women''s University, Tokyo, Japan;2. Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Japan;3. Department of Pediatrics and Child Health, Nihon University School of Medicine, Tokyo, Japan;4. Department of Emergency Medicine, Osaka Medical College, Takatsuki, Japan;5. Department of Pediatrics, Osaka Medical College, Takatsuki, Japan;6. Kyoto University Health Service, Kyoto, Japan;7. Medicine for Sports and Performing Arts, Department of Health and Sport Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan;1. Department of Pediatrics, Sainte-Justine University Hospital, University of Montreal, Montreal, Quebec, Canada;2. The Children’s Hospital of Philadelphia, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, United States;3. Department of Anesthesiology and Critical Care Medicine, United States;4. Department of Neurology, United States |
| |
| Abstract: | ObjectiveThe main objective was to study survival and neurologic evolution of children who suffered in-hospital pediatric cardiac arrest (CA). The secondary objective was to analyze the influence of risk factors on the long term outcome after CA.Methodsprospective, international, observational, multicentric study in 48 hospitals of 12 countries. CA in children between 1 month and 18 years were analyzed using the Utstein template. Survival and neurological state measured by Pediatric Cerebral Performance Category (PCPC) scale one year after hospital discharge was evaluated.Results502 patients with in-hospital CA were evaluated. 197 of them (39.2%) survived to hospital discharge. PCPC at hospital discharge was available in 156 of survivors (79.2%). 76.9% had good neurologic state (PCPC 1–2) and 23.1% poor PCPC values (3–6). One year after cardiac arrest we could obtain data from 144 patients (28.6%). PCPC was available in 116 patients. 88 (75.9%) had a good neurologic evaluation and 28 (24.1%) a poor one. A neurological deterioration evaluated by PCPC scale was observed in 40 patients (7.9%). One year after cardiac arrest PCPC scores compared to hospital discharge had worsen in 7 patients (6%), remained constant in 103 patients (88.8%) and had improved in 6 patients (5.2%).ConclusionSurvival one year after cardiac arrest in children after in-hospital cardiac arrest is high. Neurologic outcome of these children a year after cardiac arrest is mostly the same as after hospital discharge. The factors associated with a worst long-term neurological outcome are the etiology of arrest being a traumatic or neurologic illness, and the persistency of higher lactic acid values 24 h after ROSC. A standardised basic protocol even practicable for lower developed countries would be a first step for the new multicenter studies. |
| |
| Keywords: | Cardiac arrest In-hospital cardiac arrest Resuscitation Children Long-term outcome |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
