Probability of survival based on etiology of cardiopulmonary arrest in pediatric patients

Berens, Richard J.; Cassidy, Laura D.; Matchey, Jennifer; Campbell, Deborah; Colpaert, Krista D.; Welch, Tangela; Lawson, Michelle; Peterson, Cheryl; O'Flynn, Justine; Dearth, Mary; Tieves, Kelly S.

doi:10.1111/j.1460-9592.2010.03479.x

Cited by 47 publications

(21 citation statements)

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“…This finding is in agreement with data showing that the risk of cardio-respiratory arrest is higher in younger patients [14]. However, the association between a high PEWS and younger age could have many underlying causes, such as the emphasis on assessing signs of respiratory distress in this system: As the chest is more compliant in infants, this group is more likely to have retractions in the setting of respiratory diseases [15], and a PEWS ≥3 is therefore easier to attain.…”

Section: Discussionsupporting

confidence: 90%

Use of a Modified Pediatric Early Warning Score in a Department of Pediatric and Adolescent Medicine

et al. 2013

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BackgroundSeveral versions of the Pediatric Early Warning Score (PEWS) exist, but there is limited information available on the use of such systems in different contexts. In the present study, we aimed to examine the relationship between a modified version of The Brighton Paediatric Early Warning Score (PEWS) and patient characteristics in a Norwegian department of pediatric and adolescent medicine. In addition, we sought to establish guidelines for escalation in patient care based on the PEWS in our patient population.MethodsThe medical records of patients referred for acute care from March to May 2011 were retrospectively reviewed. Children with a PEWS ≥3 were compared to children with a PEWS 0–2 with regard to age, diagnostic group and indicators of severe disease.ResultsA total of 761 patients (0−18 years of age) were included in the analysis. A younger age and diagnostic groups such as lower airway and cardiovascular disease were associated with PEWS ≥3. Upper airway disease and minor injury were more frequent in patients with PEWS 0−2. Children with PEWS ≥3 received fluid resuscitation, intravenous antibiotics, and oxygen supplementation, and were transferred to a higher level of care more often than children with PEWS 0−2.ConclusionsA PEWS ≥3 was associated with severe illnesses and surrogate markers of cardio-respiratory compromise. Patients with PEWS ≥3 should be carefully monitored to prevent further deterioration.

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Section: Discussionsupporting

confidence: 90%

Use of a Modified Pediatric Early Warning Score in a Department of Pediatric and Adolescent Medicine

et al. 2013

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“…11,33 A multicenter study by Berens et al 34 involving 257 pediatric cardiac arrests found that patients with respiratory-induced arrest had a better survival at shorter CPR durations but that survival decreased dramatically with time, whereas survival after a cardiac-induced arrest remained unchanged with increasing duration of CPR. More recently, GWTG-R investigators reported that pediatric surgical cardiac patients are more likely to survive to hospital discharge after IHCA than those with medical cardiac or noncardiac disease.…”

Section: Discussionmentioning

confidence: 99%

Duration of Cardiopulmonary Resuscitation and Illness Category Impact Survival and Neurologic Outcomes for In-hospital Pediatric Cardiac Arrests

et al. 2013

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Background-Pediatric cardiopulmonary resuscitation (CPR) for >20 minutes has been considered futile after pediatric inhospital cardiac arrests. This concept has recently been questioned, although the effect of CPR duration on outcomes has not recently been described. Our objective was to determine the relationship between CPR duration and outcomes after pediatric in-hospital cardiac arrests. Methods and Results-We examined the effect of CPR duration for pediatric in-hospital cardiac arrests from the Get WithThe Guidelines--Resuscitation prospective, multicenter registry of in-hospital cardiac arrests. We included 3419 children from 328 US and Canadian Get With The Guidelines-Resuscitation sites with an in-hospital cardiac arrest between January 2000 and December 2009. Patients were stratified into 5 patient illness categories: surgical cardiac, medical cardiac, general medical, general surgical, and trauma. Survival to discharge was 27.9%, but only 19.0% of all cardiac arrest patients had favorable neurological outcomes. Between 1 and 15 minutes of CPR, survival decreased linearly by 2.1% per minute, and rates of favorable neurological outcome decreased by 1.2% per minute. Adjusted probability of survival was 41% for CPR duration of 1 to 15 minutes and 12% for >35 minutes. Among survivors, favorable neurological outcome occurred in 70% undergoing <15 minutes of CPR and 60% undergoing CPR >35 minutes. Compared with general medical patients, surgical cardiac patients had the highest adjusted odds ratios for survival and favorable neurological outcomes, 2.5 (95% confidence interval, 1.8-3.4) and 2.7 (95% confidence interval, 2.0-3.9), respectively. Conclusions-CPR duration was independently associated with survival to hospital discharge and neurological outcome.Among survivors, neurological outcome was favorable for the majority of patients. Performing CPR for >20 minutes is not futile in some patient illness categories.

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“…Most patients achieve return of spontaneous circulation (ROSC), reflecting that post-resuscitation care is a major issue in outcome. [1][2][3][4][5][6][7][8][9][10][11][12][13] High mortality has mainly been attributed to the post-resuscitation syndrome, which involves hypoxia-ischemia and reperfusion, and its potential damage to the brain. [13][14][15][16][17][18][19][20][21] Neurological injury has been related to an important decrease in survival rates after IHCA in both children and adults.…”

Section: Introductionmentioning

confidence: 99%

Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study

et al. 2015

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Probability of survival based on etiology of cardiopulmonary arrest in pediatric patients

Abstract: Probability of survival curves based on duration of CPR was statistically significantly different for CICA patients compared to RICA patients.

Cited by 47 publications

References 21 publications

Use of a Modified Pediatric Early Warning Score in a Department of Pediatric and Adolescent Medicine

Use of a Modified Pediatric Early Warning Score in a Department of Pediatric and Adolescent Medicine

Duration of Cardiopulmonary Resuscitation and Illness Category Impact Survival and Neurologic Outcomes for In-hospital Pediatric Cardiac Arrests

Long-term evolution after in-hospital cardiac arrest in children: Prospective multicenter multinational study

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