• Pediatric emergency care · Dec 2005

    Multicenter Study

    Outcome of out-of-hospital cardiorespiratory arrest in children.

    • Jesús López-Herce, Cristina García, Pedro Domínguez, Antonio Rodríguez-Núñez, Angel Carrillo, Custodio Calvo, Miguel Angel Delgado, and Spanish Study Group of Cardiopulmonary Arrest in Children.
    • Gregorio Marañón Hospital, Madrid, Spain. pielvi@ya.com
    • Pediatr Emerg Care. 2005 Dec 1; 21 (12): 807-15.

    ObjectiveTo analyze the characteristics and outcome of out-of-hospital cardiorespiratory arrest in children in Spain.MethodsSecondary analysis of data from a prospective, multicenter study analyzing cardiorespiratory arrest in children. Ninety-five children between 7 days and 16 years with cardiorespiratory arrest. Data were recorded according to the Utstein style. The outcome variables were the sustained return of spontaneous circulation (initial survival), and survival at 1 year (final survival). Neurologic and general performance outcome was assessed by the Pediatric Cerebral Performance Category (PCPC) scale and the Pediatric Overall Performance Category (POPC) scale.ResultsInitial survival was 47.3% and 1-year survival was 26.4%. Mortality was higher in children younger than 1 year. Survival of patients with respiratory arrest (82.1%) was significantly higher than survival of cardiac arrest victims (14.4%). Patients who were initially resuscitated by laypersons or paramedics had higher survival (53.6%) than those who were initially resuscitated by doctors and/or nurses (15.2%) (P < 0.01). Mortality was higher in the patients who presented slow rhythms (asystole, severe bradycardia) or pulseless electrical activity than in those presenting ventricular fibrillation (P = 0.001). Multivariate logistic regression revealed that the best indicator of mortality was duration of cardiopulmonary resuscitation longer than 20 minutes. After 1 year, most survivors had normal or mild disability.ConclusionsMortality of out-of-hospital cardiorespiratory arrest in children is high. When resuscitation is started soon by layperson or paramedics, survival is increased. Duration of resuscitation efforts is the best indicator of mortality. Most of survivors had good long-term neurologic outcome.

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