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Intensive Care Med. 2002 Mar;28(3):365-8. Epub 2002 Feb 13.

One-year survival and neurological outcome after pediatric cardiopulmonary resuscitation.

Author information

1
Department of Neonatology and Pediatric Intensive Care, University Children's Hospital, Steinwiesstrasse 75, 8032 Zurich, Switzerland.

Abstract

OBJECTIVE:

Reported survival after cardiopulmonary resuscitation (CPR) in children varies considerably. We aimed to identify predictors of 1-year survival and to assess long-term neurological status after in- or outpatient CPR.

DESIGN:

Retrospective review of the medical records and prospective follow-up of CPR survivors.

SETTING:

Tertiary care pediatric university hospital.

PATIENTS AND METHODS:

During a 30-month period, 89 in- and outpatients received advanced CPR. Survivors of CPR were prospectively followed-up for 1 year. Neurological outcome was assessed by the Pediatric Cerebral Performance Category scale (PCPC). Variables predicting 1-year survival were identified by multivariable logistic regression analysis.

INTERVENTIONS:

None.

RESULTS:

Seventy-one of the 89 patients were successfully resuscitated. During subsequent hospitalization do-not-resuscitate orders were issued in 25 patients. At 1 year, 48 (54%) were alive, including two of the 25 patients with out-of-hospital CPR. All patients died, who required CPR after trauma or near drowning, when CPR began >10 min after arrest or with CPR duration >60 min. Prolonged CPR (21-60 min) was compatible with survival (five of 19). At 1 year, 77% of the survivors had the same PCPC score as prior to CPR. Predictors of survival were location of resuscitation, CPR during peri- or postoperative care, and duration of resuscitation. A clinical score (0-15 points) based on these three items yielded an area under the ROC of 0.93.

CONCLUSIONS:

Independent determinants of long-term survival of pediatric resuscitation are location of arrest, underlying cause, and duration of CPR. Long-term survivors have little or no change in neurological status.

PMID:
11904669
DOI:
10.1007/s00134-001-1188-z
[Indexed for MEDLINE]

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