Descriptive characteristics of pediatric patients after cardiopulmonary resuscitation

Background: In the pediatrics, post-cardiac arrest syndrome represents a major cause of admission to intensive care. This study aimed to evaluate the demographics, clinical interventions, and outcomes of patients with post-cardiac arrest syndrome managed with evidence-based treatments in pediatric intensive care unit (PICU). Methods: A retrospective, single-center study, included patients hospitalized in PICU after cardiopulmonary resuscitation (CPR; out-of-hospital or in-hospital arrest) between ages of 1 month to less than 18 years from 01 January to 31 December, 2021. The following factors were assessed: demographics, cause of cardiac arrest, length of hospital stay, Pediatric Risk of Mortality Score III (PRISM III), detailed neurological examination, hospital status, arrest site duration, daytime and weekday or weekend status, CPR process, examinations and treatments. Results: The study included 60 patients (mean age: 51.21 ± 56.29 months). The mean PRISM III score was 66.01 ± 29.22, with an average hospital stay of 25.55 ± 41.96 days and a survival rate of 35%. Cardiac arrest characteristics showed asystole as the initial rhythm in 58.3% of patients. Arrests occurred predominantly during the day (81.7%) and on weekdays (70.0%). Most events were out-of-hospital (81.7%), with only 18.3% occurring in-hospital. Discharge status was significantly associated with PRISM III score (p < 0.001, odds ratio (OR) = 1.05), light reflex presence (p = 0.001, OR = 13.66), abnormal chest X-ray (p = 0.016, OR = 6.18), multiple organ failure (p = 0.003, OR = 8.43), respiratory failure (p = 0.021, OR = 7.67), and tracheostomy requirement (p = 0.040, OR = 19.00). Conclusions: Higher PRISM III scores, absent light reflex, abnormal chest X-ray, multiple organ failure, respiratory failure, and tracheostomy were significantly associated with poor discharge outcomes. Despite evidence-based care, the 35% survival rate underscores the need for improved post-resuscitation strategies in pediatric cardiac arrest cases.

Cardiopulmonary resuscitation; Pediatric; Intensive care; Mortality; Neurological sequelae

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