Abstract P39: Survey of Outcome of Cardiopulmonary Resuscitation in In-hospital Cardiac Arrest Pediatric Patients in Taiwan
Objectives: There are several reports by using Utstein’s style to report pediatric in-hospital cardiac arrest (IHCA), but none from Asia. The goal of the study is to describe the outcome of CPR in pediatric IHCA in the National Taiwan University Hospital (NTUH).
Methods: we retrospectively enrolled 254 pediatric patients with IHCA between 2000 and 2006. We excluded prematurities, perinatal asphyxia, patients who had extracorporeal life support during CPR (ECPR) or within 24 hours after CPR, and children with treatment restrictions. By using Utstein style, the primary outcome was survival to discharge, and the secondary outcome included sustained return of spontaneous circulation (ROSC) and good neurological outcomes.
Results: During the study period, 155 patients achieved sustained ROSC (61.0%) and 52 (20.5%) survived to discharge. 40 patients (15.7%) had good neurological outcomes. We also identified risk factors associated with poor outcome in this oriental cohort, including hematological/oncological patients, prolonged CPR duration and pre-CPR requirement of vasoactive infusions. Also, CPR during the night or weekend had less chances to achieve sustained ROSC.
Conclusions: This survey showed the results of CPR in pediatric IHCA in NTUH were comparable with those from Western countries. However, it seemed we performed too much CPR in cancer patients, and this is probably due to cultural differences thus the concept of palliative care should be considered. Also, establishing a balanced duty system, vigorous monitoring, preemptive management and rapid institution of advanced resuscitation may be effective to improve the outcomes.