Outcome of out-of-hospital cardiopulmonary arrest in children: A multicenter cohort study

Abstract

The aim of this study was to evaluate the demographic characteristics of children who experienced out-of-hospital cardiopulmonary arrest (CPA), and to assess the impact of the bystander cardiopulmonary resuscitation (CPR) on the survival rate of witnessed arrests and the effects of the arrest and CPR durations on the neurological outcomes. This multicenter, retrospective study included a total of 182 patients who underwent CPR for out-of-hospital CPA between January 2008 and December 2012 at six centers in Ankara, Turkey. The median [interquartile range (IQR)] age was 22 (5-54) months; 60.4% of the patients were males, and 44% were younger than one year of age. The witnessed arrest rate was 75.8% (138/182) and the rate of bystander CPR was 13.9% (13/93). In these patients the rate of the return of spontaneous circulation (ROSC) was higher (76.9%). Following resuscitation in the patients for whom the spontaneous circulation was able to be returned, the median (IQR) duration of arrest was 5 (1-15) min, while it was 15 (5-40) min for the remaining patients (p<0.001). The ROSC rate was 94.9% in patients who underwent CPR for less than 20 min and 22% in patients requiring CPR longer than 20 min (p<0.001). Survival to hospital discharge was 14.3%. Of these patients, 57.7% experienced neurological disability. The short duration of an arrest and the presence of CPR are both critical for survival. We suggest that a witness to the CPA, performing early and efficient CPR, yields better results.

The level of knowledge of pediatricians on defibrillation

“…A meta-analysis of 67 studies including subjects in all age groups found the survival rate to be lowest in Asia at 2% while it was 6% in North America, 9% in Europe, and 11% in Australia (13). The out-of-hospital cardiac arrest survival rate was 14.3% and a shockable rhythm was detected in only 4 of 182 patients at the time of diagnosis in a study conducted in the pediatric age group in our country (14). Low survival rates can be explained by the lack of training and awareness of non-hospital staff and the difficulty of accessing AED devices.…”

Self-Training Video Module Versus Instructor Taught Pediatric Basic Life Support According to Peyton Model: Report of an Experience

“…Each year 7037 children experience out-of-hospital cardiopulmonary arrest with a survival rate of 6.4%. [ 1 2 ] The most common causes of cardiopulmonary arrest in childhood are sudden infant death syndrome, trauma, and pulmonary diseases. [ 3 ] The younger the child, the higher his or her permanent neurological complications and mortality rate after cardiopulmonary arrest.…”

Knowledge and Attitudes around First Aid and Basic Life Support of Kindergarten and Elementary School Teachers and Parents in Taif City, Saudi Arabia

“…Cardiac arrest in pediatric groups is rare and most commonly due to respiratory arrest, as opposed to adult groups, when cardiac problems are more common [12]. The prognosis of in-hospital or out-of-hospital cardiopulmonary resuscitation (CPR) in pediatric groups is poor and may result in a devastating neurological deficit in the surviving patients [13,14]. According to the American Heart Association, if the heart stops beating, the first step in saving a life is to perform basic life support (BLS), starting with CPR.…”

“…To provide high-quality CPR, the provider should be well trained and understand the significance of time consumed performing CPR [14]. In order to rescue the patient's life, alleviate the pain, terminate the progression of an injury, and obtain a favorable neurological outcome, correct CPR must be administered [14,16].…”

“…To provide high-quality CPR, the provider should be well trained and understand the significance of time consumed performing CPR [14]. In order to rescue the patient's life, alleviate the pain, terminate the progression of an injury, and obtain a favorable neurological outcome, correct CPR must be administered [14,16]. This emphasizes the importance of training school teachers and parents to perform CPR, as they are the main caregivers, to improve the outcome of out-of-hospital cardiac arrest [17].…”