Outcomes After In-Hospital Pediatric Recurrent Cardiac Arrests*

Brown, Stephanie R.; Brogan, Thomas V.; McMullan, D. Michael; Roberts, Joan

doi:10.1097/pcc.0000000000002427

Cited by 5 publications

(2 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several previous investigations (5–7) have reported that AACD-CPR significantly improves the rates of ROSC and 24-h survival in patients who experienced in-hospital CA, with or without chest trauma. However, in our study, although lactic acidosis in the AACD-CPR group, which is associated with poor prognosis (32,33), was much milder compared with the STD-CPR group, this experiment did not demonstrate any increase in ROSC or survival rates at 4, 24, 48, and 72 h in the AACD-CPR group, which differs from previous reports (5–7). These inconsistencies may be attributed to the use of different resuscitation device and trial models.…”

Section: Discussioncontrasting

confidence: 99%

Comparison Between Active Abdominal Compression-Decompression Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation in Asphyctic Cardiac Arrest Rats With Multiple Rib Fractures

Dai,

Zhang,

Wang

et al. 2023

Shock

View full text Add to dashboard Cite

Background Active abdominal compression-decompression cardiopulmonary resuscitation (AACD-CPR) is potentially more effective for cardiac arrest with multiple rib fractures. However, its impact on survival rates and neurological outcomes remains unknown. This study aimed to assess if AACD-CPR improves survival rates and neurological outcomes in a rat model of asphyctic cardiac arrest with multiple rib fractures. Methods Adult male Sprague-Dawley rats were randomized into 3 groups: AACD group (n = 15), standard cardiopulmonary resuscitation (STD-CPR) group (n = 15), and sham group (n = 10), after bilateral rib fractures were surgically created and endotracheal intubation was performed. AACD-CPR and STD-CPR groups underwent 8 minutes of asphyxia followed by different CPR techniques. The sham group had venous catheterization only. Physiological variables and arterial blood gases were recorded at baseline and during a 4-hour monitoring period. Neurological deficit scores (NDS) and cumulative survival rates were assessed at 24 h, 48 h, and 72 h. NDS, serum biomarkers and hippocampal neuron analysis were used to evaluate neurological outcomes. Results No statistical differences were observed in the return of spontaneous circulation (ROSC), 24-hour, 48-hour, and 72-hour survival rates between the AACD-CPR and STD-CPR groups. AACD-CPR rats had lower serum levels of neuron-specific enolase (NSE) and S100B at 72 hours post-ROSC, and higher NDS at 72 hours post-ROSC compared to STD-CPR animals. Cellular morphology analysis, H&E staining, and TUNEL/DAPI assays showed more viable neurons and fewer apoptotic neurons in the AACD-CPR group than in the STD-CPR group. Conclusions AACD-CPR can achieve similar survival rates and better neurologic outcome after asphyxial cardiac arrest in rats with multiple rib fractures when compared to STD-CPR.

show abstract

Section: Discussioncontrasting

confidence: 99%

Comparison Between Active Abdominal Compression-Decompression Cardiopulmonary Resuscitation and Standard Cardiopulmonary Resuscitation in Asphyctic Cardiac Arrest Rats With Multiple Rib Fractures

Dai,

Zhang,

Wang

et al. 2023

Shock

View full text Add to dashboard Cite

show abstract

“…15,16 In our previous study, we found that metabolic acidosis and MODS in the peri-arrest period were associated with mortality in patients with RA. 17 In a recent singlecenter study of adult patients experiencing IHCA, lactic acidosis and RA were shown to be associated with increased mortality. 18 Severe acidosis and MODS in the peri-arrest period may reflect an acute state of inadequate oxygen delivery which is potentially reversible in which case, early initiation of ECLS may help to prevent early RA.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Pediatric In-Hospital Recurrent Cardiac Arrest

Brown

Roberts

Killien

et al. 2022

J Pediatr Intensive Care

Self Cite

View full text Add to dashboard Cite

The objective of this article was to identify demographic and clinical factors associated with early recurrent arrest (RA) (<48 hours) and late RA (≥48 hours) among pediatric inpatients following an initial in-hospital cardiac arrest. A retrospective cohort study of inpatients was performed in a free-standing academic quaternary care children's hospital. All inpatients were <18 years old with a cardiac arrest event requiring ≥1 minute of cardiopulmonary resuscitation with the return of spontaneous circulation sustained for ≥20 minutes at Seattle Children's Hospital from February 1, 2012 to September 18, 2019. Of the 237 included patients, 20 (8%) patients had an early RA and 30 (13%) had a late RA. Older age and severe pre-arrest acidosis were associated with a higher risk of early RA, odds ratios (OR) 1.2 (95% confidence interval [CI] 1.1–1.3) per additional year and 4.6 (95% CI 1.2–18.1), respectively. Pre-arrest organ dysfunction was also associated with a higher risk of early RA with an OR of 3.3 (95% CI 1.1–9.4) for respiratory dysfunction, OR 1.4 (95% CI 1.1–1.9) for each additional dysfunctional organ system, and OR 1.1 (95% CI 1–1.2) for every one-point increase in PELOD2 score. The neonatal illness category was associated with a lower risk of late RA, OR 0.3 (95% CI 0.1–0.97), and severe post-arrest acidosis was associated with a higher risk of late RA, OR 4.2 (95% CI 1.1–15). Several demographic and clinical factors offer some ability to identify children who sustain a recurrent cardiac arrest, offering a potential opportunity for intervention to prevent early recurrent arrest.

show abstract