Abstract
Aim: Diastolic blood pressure (DBP) during cardiopulmonary resuscitation (CPR) is associated with survival following pediatric in-hospital cardiac arrest. The relationship between intra-arrest haemodynamics and neurological status among survivors of pediatric cardiac arrest is unknown. Methods: This study represents analysis of data from the prospective multicenter Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) Study. Primary predictor variables were median DBP and median systolic blood pressure (SBP) over the first 10 min of CPR. The primary outcome measure was “new substantive morbidity” determined by Functional Status Scale (FSS) and defined as an increase in the FSS of at least 3 points or increase of 2 in a single FSS domain. Univariable analyses were completed to investigate the relationship between new substantive morbidity and BPs during CPR. Results: 244 index CPR events occurred during the study period, 77 (32%) CPR events met all inclusion criteria as well as having both DBP and FSS data available. Among 77 survivors, 32 (42%) had new substantive morbidity as measured by the FSS score. No significant differences were identified in DBP (median 30.5 mmHg vs. 30.9 mmHg, p = 0.5) or SBP (median 76.3 mmHg vs. 63.0 mmHg, p = 0.2) between patients with and without new substantive morbidity. Children who developed new substantive morbidity were more likely to have lower pre-arrest FSS than those that did not (median [IQR]: 7.5 [6.0–9.0] versus 9.0 [7.0–13.0], p = 0.01). Conclusion: New substantive morbidity determined by FSS after a pediatric IHCA was associated with baseline functional status, but not DBP during CPR.
Original language | English (US) |
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Pages (from-to) | 57-65 |
Number of pages | 9 |
Journal | Resuscitation |
Volume | 143 |
DOIs | |
State | Published - Oct 2019 |
Funding
This study was supported, in part, by the following cooperative agreements from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Department of Health and Human Services: UG1HD050096, UG1HD049981, UG1HD049983, UG1HD063108, UG1HD083171, UG1HD083166, UG1HD083170, U10HD050012, U10HD063106, U10HD063114 and U01HD049934. Supported, in part, by the following cooperative agreements from the Eunice Kennedy Shriver National Institute of Child Health and Human Development , National Institutes of Health , Department of Health and Human Services : UG1HD050096, UG1HD049981, UG1HD049983, UG1HD063108, UG1HD083171, UG1HD083166, UG1HD083170, U10HD050012, U10HD063106, U10HD063114 and U01HD049934. The Authors have the following disclosures. Dr. Wolfe has received research funding from NHLBI (funds to institution), as well as speaking honoraria from Zoll Medical. Robert A Berg received research grants from NHLBI and NICHD to study pediatric in-hospital cardiopulmonary resuscitation (funds to institution), as well as speaking honoraria from Japan Pediatric Society for lecture on pediatric cardiopulmonary resuscitation. Dr. Sutton has received research grants from NHLBI and NICHD to study pediatric in-hospital cardiopulmonary resuscitation (funds to institution), Pediatric Advance Life Support authorship via the American Heart Association, membership on the Emergency Cardiovascular Care Committee and past speaking honoraria for Zoll Medical. The rest of the authors report no COI.
Keywords
- Cardiac arrest
- Cardiopulmonary resuscitation (CPR)
- In-hospital
- Outcomes
- Pediatric
- Survival
ASJC Scopus subject areas
- Emergency Medicine
- Emergency
- Cardiology and Cardiovascular Medicine