1314: HIGH-STAKES MOMENTS: OUTCOMES OF PEDIATRIC IN-HOSPITAL CARDIAC ARRESTS IN THE ICU

Le résumé fourni par la source

Introduction: Cardiopulmonary resuscitation (CPR) is a vital intervention for children with severe respiratory distress or asystole. Although pediatric in-hospital cardiac arrests are rare, they carry a high mortality. Survival rates vary between 25–50% timely, effective CPR, including early defibrillation and post-arrest care, significantly improves outcomes. Despite its importance, local data on CPR incidence and outcomes are limited. This study aimed to determine the frequency and outcomes of CPR in the PICU. Methods: A retrospective observational study was conducted on all the Children (1 month to 18 years of age) admitted to the PICU from January 2018 to December 2023. Demographics, diagnosis, and details of CPR, including total number of cycles, vitals, medications, and outcomes, were documented. Frequencies and percentages were calculated for categorical data. Results: Among 4,026 PICU admissions, 165 patients (0.41%) required 297 CPR events. Return of spontaneous circulation (ROSC) was achieved in 98 patients (59.3%). Survival at 48 hours post-CPR was 18.1% (30/165), declining to 12.7% (21/165) at PICU discharge, 12.1% (20/165) at hospital discharge, and 6% (10/165) at four weeks. The mean age was 4.82 ± 5.21 years. Non-cardiac diagnoses accounted for 60.6% of admissions, followed by cardiac 31.5% and surgical (5.4%) cases. Multiple organ dysfunction syndrome (MODS) was present in 40.6% (67/165). The mean CPR duration was 12.86 ± 13 minutes, with 6.09 ± 5.24 cycles performed. Pulseless electrical activity (PEA) was the most common initial rhythm (42.4%), while 23% required defibrillation. A total of 24.4% were designated do-not-resuscitate (DNR) after the first CPR episode. At PICU discharge, Mortality was increased with repeated CPR events and duration of CPR, which was statistically significant. Conclusions: CPR frequency in our PICU was low, but survival beyond discharge remained poor. Identifying and addressing modifiable factors could enhance CPR outcomes and long-term recovery in pediatric patients.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.