Clinical paperEffectiveness and long-term outcome of cardiopulmonary resuscitation in paediatric intensive care units in Spain☆
Introduction
Critically ill children have a high risk of complications that can lead to cardiorespiratory arrest (CRA). Resuscitation includes procedures and treatments that are immediately available in the critical care setting and the best possible results in terms of survival and neurological outcome should be obtained.1, 2, 3 However, little has been published about the actual effectiveness and long-term outcome of resuscitation in this subset of patients, and most of the data are difficult to interpret because the studies have been retrospective or included patients having suffered CRA at different in-hospital sites.4, 5, 6, 7, 8
The Utstein style provides uniform guidelines for reporting characteristics and outcome for in-hospital and out-of-hospital CRA in children.8, 10 To date, only one prospective study that analyses, in a single centre, the outcome of in-hospital CRA in children following the Utstein style guidelines has been reported.5
The purpose of the present study was to provide an Utstein style prospective and multicentre report of children who suffered a CRA when admitted to PICU and to evaluate factors associated with survival as well as short and long-term neurological outcome.
Section snippets
Patients and methods
An invitation to participate in the study was sent to 26 paediatric intensive care units (PICU) in Spain.11, 12 A protocol was drawn up in accordance with the Utstein style guidelines.9, 10 This is a secondary analysis of data from a study of cardiopulmonary arrest in Spain; the methodology and primary results of which have been described elsewhere.11, 12 Patients admitted to PICU and aged from 7 days to 18 years were eligible to be included in the present study if they presented emergency
Results
We studied 116 children who presented with a cardiorespiratory arrest while they were hospitalised in 16 PICUs (in-PICU CRA), 71 males (61.2%) and 45 females (38.8%), with a mean age of 37.7 ± 48.7 months (range: 0.1–204 months) and mean weight of 14.3 ± 15.6 kg (range: 2.3–80 kg). This population represents 41% of the 283 children with CRA previously reported.11, 12
In 80 patients (69.0%) resuscitation (CPR) achieved ROSC, that was sustained in 69 (59.5%). In 20 patients (17.2%) restoration of
Discussion
Cardiorespiratory arrest is a rare but relatively expected event in critically ill children.1, 7, 8 However, there is a surprisingly lack of data about the immediate and long-term results of CPR in this specific population.1, 2, 3, 4, 5, 6, 7 The aim of our study was to focus on the data of paediatric CRA occurring in all types of patients admitted to PICU, and to assess the long-term neurological outcome. This is the first prospective and multicentre study of paediatric CPR in PICUs using the
Conflict of interest
None.
Acknowledgment
This study has been supported by a Grant from the Fondo de Investigaciones Sanitarias, 00/0288.
References (21)
- et al.
Paediatric cardiopulmonary-cerebral resuscitation: an overview and future directions
Crit Care Clin
(2003) - et al.
Paediatric cardiopulmonary resuscitation: s collective review
Ann Emerg Med
(1999) - et al.
Utstein style reporting of-inhospital paediatric cardiopulmonary resuscitation
Resuscitation
(2000) - et al.
Recommended Guidelines for uniform reporting of paediatric advanced life support: the paediatric Utstein style
Resuscitation
(1995) - et al.
Recommended guidelines for reviewing, reporting, and conducting research on in hospital resuscitation: the in-hospital “Utstein style”
Resuscitation
(1997) - et al.
Characteristics and outcome of cardiorespiratory arrest in children
Resuscitation
(2004) - et al.
Long-term outcome of Paediatric cardio-respiratory arrest in Spain
Resuscitation
(2005) Assessing the outcome of Paediatric intensive care
J Pediatr
(1992)- et al.
One-year survival and neurological outcome after paediatric cardiopulmonary resuscitation
Intensive Care Med
(2002) - et al.
Cardiopulmonary resuscitation in a paediatric ICU
Crit Care Med
(1986)
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A Spanish translated version of the summary of this article appears as Appendix in the online version at doi:10.1016/j.resuscitation.2005.11.020.
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List of study collaborators: Antonio Rodríguez-Núñez (Hospital Clínico Universitario, Santiago de Compostela), Jesús López-Herce, Cristina García, Angel Carrillo (Hospital G.U. Gregorio Marañón, Madrid), Custodio Calvo (Hospital Materno-Infantil, Malaga), Pedro Domínguez (Hospital Vall d’Hebrón, Barcelona), Miguel Angel Delgado (Hospital Infantil La Paz, Madrid), Maria A. García (Hospital Niño Jesús, Madrid), Corsino Rey (Hospital Central de Asturias, Oviedo), Teresa Hermana (Hospital de Cruces, Baracaldo), Jose A. Alonso (Hospital Virgen de la Salud, Toledo), Julio Melendo (Hospital Miguel Servet, Zaragoza), Josefina Cano (Hospital Virgen del Rocío, Sevilla), Servando Pantoja (Hospital Puerta del Mar, Cádiz), Alvaro Díaz (Hospital Tarrasa, Barcelona), Ricardo Martino (Hospital Príncipe de Asturias, Alcalá de Henares), Maria V. Esteban (Hospital Princesa de España, Jaén), Esther Ocete (Hospital Clínico, Granada), Juan I. Muñoz (Hospital Reina Sofía, Córdoba), Amelia Sánchez-Galindo (Hospital Juan Canalejo, La Coruña), Antonio Gómez Calzado (Hospital Virgen Macarena, Sevilla). Statistical data analysis: Jose M Bellón and Maria La Calle (Gregorio Marañón Hospital, Madrid).