Outcome of cardiopulmonary resuscitation in a pediatric cardiac intensive care unit

Abstract

After cardiopulmonary resuscitation in this pediatric CICU, the rate of success was 63% and the rate of survival was 42%. Prior cardiac surgery and use of epinephrine before arrest did not influence the outcome of CPR. The availability of effective mechanical cardiopulmonary support can improve the outcome of CPR.

Multidisciplinary Review of Code Events in a Heart Center

“…They defined a "failure to rescue" rate as the ability to prevent a clinically important deterioration (ie, death or permanent disability) from a complication. 16 Review of cardiac surgical data at our institution demonstrates that our overall incidence of cardiopulmonary arrests is similar to the incidences reported in other published data series 3,4,17 at 3% to 6% per year. The Get With The Guidelines-Resuscitation database www.ajcconline.org report 13 from 2011 reported a subgroup of cardiac surgical patients with a survival to discharge of 37%, which was similar to our experience in 2010 and 2011.…”

“…1 However, the incidence of cardiopulmonary arrest within pediatric critical care settings is nearly 10-fold higher, with 9.4 cardiopulmonary arrests per 1000 admissions, and the rate is even higher in dedicated pediatric cardiac intensive care units (40-60/1000 admissions). [2][3][4] Achievement of optimal outcomes for life-threatening events depends on rapid identification of deteriorating condition, high-quality resuscitation, and optimal performance of a multidisciplinary team. Ideally, the goal is to prevent cardiopulmonary arrest with interventions initiated by a rapid response team or in cases where cardiopulmonary arrest is imminent, the intensive care unit team.…”

Part 12: Cardiac Arrest in Special Situations

“…529,[542][543][544] In post-cardiac surgery patients who are refractory to standard resuscitation procedures, mechanical circulatory support (eg, extracorporeal membrane oxygenation and cardiopulmonary bypass) may be effective in improving outcome (Class IIb, LOE B).…”

Part 14: Pediatric Advanced Life Support

“…6,7,[11][12][13]15,16,151,[485][486][487][488][489] None of these associations, however, predict outcome. Witnessed collapse, bystander CPR, and a short interval from collapse to arrival of professionals improve the chances of a successful resuscitation.…”