Factors associated with sustained return of spontaneous circulation in children after out-of-hospital cardiac arrest of noncardiac origin
Received 27 September 2008; received in revised form 28 November 2008; accepted 13 December 2008. published online 08 February 2010.
Abstract
Purpose
The study aimed to determine the factors predictive of sustained return of spontaneous circulation (ROSC) in children with out-of-hospital cardiac arrest (OHCA) of noncardiac origin.
Methods
Eighty children were included in this retrospective study. The variables that lead to sustained ROSC and those that do not lead to sustained ROSC were analyzed. Survival analyses, including chance of achieving sustained ROSC and sum duration of ROSC, were conducted according to the duration of in-hospital cardiopulmonary resuscitation (CPR).
Results
Etiologies of noncardiac OHCA differed significantly across different age groups (P < .001). Only 8.8% of children had initial arrest rhythms that were shockable. Predictors of sustained ROSC included the initial cardiac rhythm (P = .002), a shorter period between collapse and the first chest compression (P = .002), a shorter in-hospital CPR duration (P = .004), and prehospital CPR (P = .007). In children where ROSC was initially sustained, those with in-hospital CPR of more than 20 minutes, ROSC was sustained for less time (P < .001).
Conclusions
Few children with noncardiac OHCA present with shockable cardiac rhythms. Furthermore, long-term ROSC is difficult to maintain in children who receive in-hospital CPR for more than 20 minutes.
aDepartment of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
bDepartment of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
cInstitute of Medicine, Chungshan Medical University, Taichung, Taiwan
dDepartment of Biological Science and Technology and Institute of Biochemical Engineering, National Chiao Tung University, Hsinchu, Taiwan
Corresponding author. Department of Emergency Medicine, Changhua Christian Hospital, Changhua 500, Taiwan. Tel.: +886 4 7238595x1374; fax: +886 4 7289233.
ABSTRACT