Outcome of in-hospital pediatric cardiac arrest

Background: The outcome of pediatric cardiac arrest is poor, and attempts to improve it have not been very successful. The aim of this study was to analyze the outcome of a large number of in-hospital pediatric cardiac arrest patients, and to determine the factors that influence this outcome. Patients and Methods: The records of hospital inpatients at King Faisal Specialist Hospital and Research Centre who received external cardiac massage as part of their cardiopulmonary resuscitation were reviewed. Success of resuscitation was analyzed as: 1) short-term (restoration of spontaneous circulation); and 2) long-term (discharge from hospital). Results: Of 234 such patients, 171 (73.1%) survived the initial resuscitation, and 66 (28.2%) were discharged from hospital. Success of outcome was not related to age, time of day, or location of arrest. Longer resuscitation time was associated with less chance of restoration of spontaneous circulation (P < 0.001), and lower hospital discharge rate. Results for patients with congenital heart disease were similar to those with other medical or surgical conditions. Restoration of spontaneous circulation from asystole was more difficult when compared to other arrest rhythm, but once circulation was restored, long-term outcome was not influenced by rhythm. Conclusion: Asystole and longer resuscitation time are associated with poorer outcome, however, successful restoration of spontaneous circulation with long-term survival can be achieved after prolonged resuscitation.