Document Detail

Higher survival rates among younger patients after pediatric intensive care unit cardiac arrests.
MedLine Citation:
PMID:  17142528     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Age is an important determinant of outcome from adult cardiac arrests but has not been identified previously as an important factor in pediatric cardiac arrests except among premature infants. Chest compressions can result in more effective blood flow during cardiac arrest in an infant than an older child or adult because of increased chest wall compliance. We, therefore, hypothesized that survival from cardiac arrest would be better among infants than older children. METHODS: We evaluated 464 pediatric ICU arrests from the National Registry of Cardiopulmonary Resuscitation from 2000 to 2002. NICU cardiac arrests were excluded. Data from each arrest include >200 variables describing facility, patient, prearrest, arrest intervention, outcome, and quality improvement data. Age was categorized as newborn (<1 month; N = 62), infant (1 month to <1 year; N = 105), younger child (1 year to <8 years; N = 90), and older child (8 years to <21 years; N = 207). Multivariable logistic regression was performed to examine the association between age and survival. RESULTS: Overall survival was 22%, with 27% of newborns, 36% of infants, 19% of younger children and 16% of older children surviving to hospital discharge. Newborns and infants demonstrated double and triple the odds of surviving to hospital discharge from a cardiac arrest in an intensive care setting when compared with older children. When potential confounders were controlled, newborns increased their advantage to almost fivefold, while infants maintained their survival advantage to older children. CONCLUSIONS: Survival from pediatric ICU cardiac arrest is age dependent. Newborns and infants have better survival rates even after adjusting for potential confounding variables.
Peter A Meaney; Vinay M Nadkarni; E Francis Cook; Marcia Testa; Mark Helfaer; William Kaye; G Luke Larkin; Robert A Berg;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  118     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-04     Completed Date:  2006-12-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2424-33     Citation Subset:  AIM; IM    
Department of Critical Care Medicine, 7th Floor, Room 7c03, Children's Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, USA.
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MeSH Terms
Age Factors
Child, Preschool
Heart Arrest / mortality*,  therapy*
Infant, Newborn
Intensive Care*
Intensive Care Units, Pediatric
Prospective Studies
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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