Department of Pediatrics and Child Health, Aga Khan University Hospital, Stadium Road, Karachi 74800, Pakistan.
Indian J Pediatr. 2011 Nov;78(11):1356-60. doi: 10.1007/s12098-011-0439-4. Epub 2011 May 28.
To review the incidence and outcome of in-hospital pediatric cardiopulmonary arrest (CPA).
This retrospective six-year case series was carried out at the PICU and Pediatric Units of Aga Khan University Hospital (AKUH). All children aged 1 month to 14 years who underwent cardiopulmonary resuscitation from January 2001 through December 2006 were included. Data were recorded according to the Utstein style. The outcome variables were sustained return of spontaneous circulation (initial survival) and hospital discharge (final survival). Factors associated with survival were evaluated using logistic regression analysis.
The incidence of CPA was 0.4% of all the admissions. Most of the CPR attempts took place in pediatric intensive care unit (53%) and the most frequent etiology was shock (78%). After initial CPR, the sustained return of spontaneous circulation was achieved in 58 patients (55%). Only 12 patients (11%) were discharged alive from the hospital. The most common initial documented rhythm was bradycardia (78%). Multivariate logistic regression analysis revealed that prolonged duration of CPR (>20 min) was the best predictor of initial and final mortality (p < 0.001).
The survival rate of in-hospital pediatric cardiopulmonary arrest in the present report is low.
回顾院内儿科心搏骤停（CPA）的发生率和结局。
本回顾性六年前瞻性研究在 Aga Khan 大学医院（AKUH）的儿科重症监护病房（PICU）和儿科病房进行。纳入 2001 年 1 月至 2006 年 12 月期间行心肺复苏术的 1 个月至 14 岁儿童。数据根据 Utstein 风格进行记录。结局变量为自主循环的持续恢复（初始存活）和出院（最终存活）。使用逻辑回归分析评估与生存相关的因素。
CPA 的发生率为所有入院患者的 0.4%。大多数心肺复苏术发生在儿科重症监护病房（53%），最常见的病因是休克（78%）。初始心肺复苏后，58 名患者（55%）实现了自主循环的持续恢复。仅有 12 名患者（11%）从医院出院时存活。最初记录的最常见节律是心动过缓（78%）。多变量逻辑回归分析显示，心肺复苏时间延长（>20 分钟）是初始和最终死亡率的最佳预测因素（p<0.001）。
本报告中院内儿科心搏骤停的存活率较低。
