• Robert Christensen, Terri Voepel-Lewis, Ian Lewis, Satya Krishna Ramachandran, Shobha Malviya, and American Heart Association's Get With The Guidelines-Resuscitation (formerly the National Registry of Cardiopulmonary Resuscitation) investigators.
• Department of Anesthesiology, University of Michigan Health System, Ann Arbor 48109, USA. robertec@med.umich.edu
• Paediatr Anaesth. 2013 Jun 1;23(6):517-23.

BackgroundNearly 20% of anesthesia-related pediatric cardiopulmonary arrests (CPAs) occur during emergence or recovery. The aims of this study were to describe (i) the nature of pediatric postanesthesia care unit (PACU) CPA and subsequent outcomes and (ii) factors associated with mortality.MethodsCardiopulmonary Arrests occurring in PACU in children (<18 years) were identified from the American Heart Association Get With The Guidelines-Resuscitation, multicenter CPA registry. Demographics, underlying conditions, cause(s) of CPA, monitoring, interventions and outcomes were extracted. Descriptive statistics were used to characterize data, and odds ratios (OR) with confidence intervals (CI) were calculated as appropriate to compare survivors and nonsurvivors.ResultsTwenty seven CPA events were included: 67% in children <5 years and 30% in infants (<1 year). Most children (78%) had underlying comorbidities, including 15% with congenital heart disease. Respiratory issues were the most frequent causes of CPA (44%), but cardiac/hemodynamic causes were associated with nonsurvival (P = 0.01). Nonsurvival was also associated with older age (P = 0.02), weekend occurrence (P < 0.01), nonpediatric setting (P = 0.02) and occurrence at night (P = 0.04).ConclusionsThis study identified similar risk factors and underlying causes as described in previous reports of pediatric perioperative CPA, with higher mortality following a cardiac/hemodynamic cause.© 2013 Blackwell Publishing Ltd.

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