Document Detail

Outcome following cardiopulmonary resuscitation in the neonate requiring ventilatory assistance.
MedLine Citation:
PMID:  10959016     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: there is limited data regarding the clinical characteristics and outcome of the neonate requiring ventilatory assistance who develops persistent bradycardia (PB) requiring cardiopulmonary resuscitation (CPR). OBJECTIVES: (1) to determine the percentage of newborn infants requiring respiratory assistance who develop PB and require CPR as part of resuscitation; (2) the associated clinical events; and (3) the short term outcome. METHODS: the medical charts of infants admitted to a neonatal intensive care unit who developed PB, defined as a heart rate <80 beats/min requiring CPR, were retrospectively reviewed. RESULTS: for 3 years, 39 (2.6%) of 1485 infants exhibited 62 episodes of PB requiring CPR; this represents 5.6% of 695 intubated infants. Fourteen (36%) infants rapidly responded to chest compressions only with restoration of heart rate within 2 min; termed brief CPR. None died in-hospital. Twenty-five (64%) infants required prolonged chest compressions, i.e. >2 min (termed prolonged CPR); 21 also received epinephrine. The median postnatal age at onset of CPR was 20 days (range 1-148 days) and the duration of CPR was 10 min (range 3-73 min). The more common medical conditions that may have contributed to the PB included severe bronchospasm associated with chronic lung disease (CLD) (n=6), shock associated with sepsis (n=4) and necrotizing enterocolitis (NEC) (n=2), pneumothorax (n=2), inadequate or improper ventilation (n=3), other (n=8). Nineteen (76%) infants died: 13 within 24 h of the event and six from 3 to 194 days following CPR. At 18 months follow-up, four of the six infants evaluated have a moderate to severe neurodevelopmental deficit. Of the nine infants requiring brief CPR who were evaluated, five are developing normally and four have a moderate to severe neurodevelopmental deficit. CONCLUSION: CPR in the neonate who requires ventilatory assistance is not uncommon. When brief in nature, mortality is low and short-term outcome is likely to be determined by the underlying medical condition. When CPR is prolonged, mortality is high and short-term outcome is poor.
S Chamnanvanakij; J M Perlman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Resuscitation     Volume:  45     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-10-17     Completed Date:  2000-10-17     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  173-80     Citation Subset:  IM    
Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX 75235-9063, USA.
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MeSH Terms
Bradycardia / etiology,  mortality,  therapy*
Cardiopulmonary Resuscitation*
Chronic Disease
Developmental Disabilities / epidemiology
Epinephrine / administration & dosage,  therapeutic use
Infant, Newborn
Lung Diseases / complications,  mortality
Respiration, Artificial*
Retrospective Studies
Survival Analysis
Time Factors
Treatment Outcome
Reg. No./Substance:

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