Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR

for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators

doi:10.1016/j.resuscitation.2019.08.006

Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR

for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators

Pediatrics

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

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)
Pages (from-to)	57-65
Number of pages	9
Journal	Resuscitation
Volume	143
DOIs	https://doi.org/10.1016/j.resuscitation.2019.08.006
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

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10.1016/j.resuscitation.2019.08.006

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for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators (2019). Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR. Resuscitation, 143, 57-65. https://doi.org/10.1016/j.resuscitation.2019.08.006

for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators. / Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR. In: Resuscitation. 2019 ; Vol. 143. pp. 57-65.

@article{5e65888ffa1441cc883ac5d143eb4737,

title = "Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR",

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.",

keywords = "Cardiac arrest, Cardiopulmonary resuscitation (CPR), In-hospital, Outcomes, Pediatric, Survival",

author = "{for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators} and Wolfe, {Heather A.} and Sutton, {Robert M.} and Reeder, {Ron W.} and Meert, {Kathleen L.} and Pollack, {Murray M.} and Yates, {Andrew R.} and Berger, {John T.} and Newth, {Christopher J.} and Carcillo, {Joseph A.} and McQuillen, {Patrick S.} and Harrison, {Rick E.} and Moler, {Frank W.} and Carpenter, {Todd C.} and Notterman, {Daniel A.} and Richard Holubkov and Dean, {J. Michael} and Nadkarni, {Vinay M.} and Berg, {Robert A.} and Zuppa, {Athena F.} and Katherine Graham and Carolann Twelves and Diliberto, {Mary Ann} and Elyse Tomanio and Jeni Kwok and Bell, {Michael J.} and Alan Abraham and Anil Sapru and Alkhouli, {Mustafa F.} and Sabrina Heidemann and Ann Pawluszka and Hall, {Mark W.} and Lisa Steele and Shanley, {Thomas P.} and Monica Weber and Dalton, {Heidi J.} and Bell, {Aimee La} and Mourani, {Peter M.} and Kathryn Malone and Russell Telford and Christopher Locandro and Whitney Coleman and Alecia Peterson and Julie Thelen and Allan Doctor",

note = "Publisher Copyright: {\textcopyright} 2019 Elsevier B.V.",

year = "2019",

month = oct,

doi = "10.1016/j.resuscitation.2019.08.006",

language = "English (US)",

volume = "143",

pages = "57--65",

journal = "Resuscitation",

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for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators 2019, 'Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR', Resuscitation, vol. 143, pp. 57-65. https://doi.org/10.1016/j.resuscitation.2019.08.006

Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR. / for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators.
In: Resuscitation, Vol. 143, 10.2019, p. 57-65.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR

AU - for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators

AU - Wolfe, Heather A.

AU - Sutton, Robert M.

AU - Reeder, Ron W.

AU - Meert, Kathleen L.

AU - Pollack, Murray M.

AU - Yates, Andrew R.

AU - Berger, John T.

AU - Newth, Christopher J.

AU - Carcillo, Joseph A.

AU - McQuillen, Patrick S.

AU - Harrison, Rick E.

AU - Moler, Frank W.

AU - Carpenter, Todd C.

AU - Notterman, Daniel A.

AU - Holubkov, Richard

AU - Dean, J. Michael

AU - Nadkarni, Vinay M.

AU - Berg, Robert A.

AU - Zuppa, Athena F.

AU - Graham, Katherine

AU - Twelves, Carolann

AU - Diliberto, Mary Ann

AU - Tomanio, Elyse

AU - Kwok, Jeni

AU - Bell, Michael J.

AU - Abraham, Alan

AU - Sapru, Anil

AU - Alkhouli, Mustafa F.

AU - Heidemann, Sabrina

AU - Pawluszka, Ann

AU - Hall, Mark W.

AU - Steele, Lisa

AU - Shanley, Thomas P.

AU - Weber, Monica

AU - Dalton, Heidi J.

AU - Bell, Aimee La

AU - Mourani, Peter M.

AU - Malone, Kathryn

AU - Telford, Russell

AU - Locandro, Christopher

AU - Coleman, Whitney

AU - Peterson, Alecia

AU - Thelen, Julie

AU - Doctor, Allan

PY - 2019/10

Y1 - 2019/10

N2 - 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.

AB - 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.

KW - Cardiac arrest

KW - Cardiopulmonary resuscitation (CPR)

KW - In-hospital

KW - Outcomes

KW - Pediatric

KW - Survival

UR - http://www.scopus.com/inward/record.url?scp=85070898041&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070898041&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2019.08.006

DO - 10.1016/j.resuscitation.2019.08.006

M3 - Article

C2 - 31404636

AN - SCOPUS:85070898041

SN - 0300-9572

VL - 143

SP - 57

EP - 65

JO - Resuscitation

JF - Resuscitation

ER -

for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) investigators. Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR. Resuscitation. 2019 Oct;143:57-65. doi: 10.1016/j.resuscitation.2019.08.006

Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR

Abstract

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