Factors influencing outcome of inpatient pediatric resuscitation

Abstract

The aims of this study were: 1) To define the rate of long-term survivors (LTS) after cardiopulmonary resuscitation (CPR) in children; 2) To identify the predictors of survival in pediatric resuscitation; and 3) To assess the outcome six months after discharge. Three groups of patients were identified based on outcome: 1. Long-term survivors (LTS), who were discharged, 2. Short-term survivors (STS), who survived longer than 24 hours after CPR but not until discharge, and 3. Nonsurvivors (NS), who died within 24 hours after their arrest. Of the 67 patients, 10 (14.9%) children were STS, while 46 (68.7%) were NS. Only eleven (16.4%) were LTS who were eventually discharged from the hospital and six were alive six months after discharge. Four patients had neurological sequelae. Less than 5 minutes' duration of CPR and reactive pupils at the onset of cardiopulmonary arrest (CPA) were the most important factors that predicted long term survival. We suggest that a positive pupillary light reflex at the onset of CPA and the duration of CPR should be considered as important predictors of survival in children with CPA.