Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

Satoshi Matsui, Tomotaka Sobue, Taro Irisawa, Tomoki Yamada, Koichi Hayakawa, Kazuhisa Yoshiya, Kazuo Noguchi, Tetsuro Nishimura, Takuya Ishibe, Yoshiki Yagi, Takeyuki Kiguchi, Masafumi Kishimoto, Hiroshi Shintani, Yasuyuki Hayashi, Taku Sogabe, Takaya Morooka, Haruko Sakamoto, Keitaro Suzuki, Fumiko Nakamura, Norihiro Nishioka, Yohei Okada, Tasuku Matsuyama, Junya Sado, Takeshi Shimazu, Ryojiro Tanaka, Hiroshi Kurosawa, Taku Iwami, Tetsuhisa Kitamura
International Heart Journal 2020 March 14
The effect of post-cardiac arrest care in children with out-of-hospital cardiac arrest (OHCA) has not been adequately established, and the long-term outcome after pediatric OHCA has not been sufficiently investigated. We describe here detailed in-hospital characteristics, actual management, and survival, including neurological status, 90 days after OHCA occurrence in children with OHCA transported to critical care medical centers (CCMCs).We analyzed the database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study, which is a multicenter, prospective observational data registry designed to accumulate both pre- and in-hospital data on OHCA treatments. We enrolled all consecutive pediatric patients aged <18 years who had an OHCA and for whom resuscitation was attempted and who were transported to CCMCs between 2012 and 2016.A total of 263 pediatric patients with OHCA were enrolled. The average age of the patients was 6.3 years, 38.0% were aged < 1 year, and 60.8% were male. After hospital arrival, 4.9% of these pediatric patients received defibrillation; 1.9%, extracorporeal life support; 6.5%, target temperature management; and 88.2% adrenaline administration. The proportions of patients with 90-day survival and a pediatric cerebral performance category (PCPC) score of 1 or 2 were 6.1% and 1.9%, respectively. The proportion of patients with a PCPC score of 1 or 2 at 90 days after OHCA occurrence did not significantly improve during the study period.The proportion of pediatric patients with a 90-day PCPC score of 1 or 2 transported to CCMCs was extremely low, and no significant improvements were observed during the study period.

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