Lee En-Pei, Chan Oi-Wa, Lin Jainn-Jim, Hsia Shao-Hsuan, Wu Han-Ping
Division of Pediatric Critical Care Medicine, and Pediatric Sepsis Study Group, Department of Pediatrics, Chang Gung Memorial Hospital at Linko, Taoyuan, Taiwan.
College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Front Pediatr. 2022 Apr 4;10:834746. doi: 10.3389/fped.2022.834746. eCollection 2022.
In the pediatric intensive care unit (PICU), cardiac arrest (CA) is rare but results in high rates of morbidity and mortality. A retrospective chart review of 223 patients who suffered from in-PICU CA was analyzed from January 2017 to December 2020. Outcomes at discharge were evaluated using pediatric cerebral performance category (PCPC). Return of spontaneous circulation was attained by 167 (74.8%) patients. In total, only 58 (25%) patients survived to hospital discharge, and 49 (21.9%) of the cohort had good neurologic outcomes. Based on multivariate logistic regression analysis, vasoactive-inotropic drug usage before CA, previous PCPC scale >2, underlying hemato-oncologic disease, and total time of CPR were risk factors associated with poor outcomes. Furthermore, we determined the cutoff value of duration of CPR in predicting poor neurologic outcomes and in-hospital mortality in patients caused by in-PICU CA as 17 and 23.5 min respectively.
在儿科重症监护病房（PICU），心脏骤停（CA）很少见，但发病率和死亡率很高。对2017年1月至2020年12月期间223例在PICU发生CA的患者进行了回顾性病历分析。出院时的结局采用儿科脑功能表现分类（PCPC）进行评估。167例（74.8%）患者实现了自主循环恢复。总体而言，只有58例（25%）患者存活至出院，该队列中有49例（21.9%）患者神经功能结局良好。基于多因素逻辑回归分析，CA前使用血管活性药物、既往PCPC评分>2、潜在血液肿瘤疾病以及心肺复苏总时长是与不良结局相关的危险因素。此外，我们确定PICU CA所致患者神经功能不良结局和院内死亡的心肺复苏时长临界值分别为17分钟和23.5分钟。
