Factors associated with sustained return of spontaneous circulation in children after out-of-hospital cardiac arrest of noncardiac origin

Li, Chao-Jui; Kung, Chia-Te; Liu, Ber-Ming; Chou, Chu-Chung; Chang, Chin-Fu; Wu, Tung-Kung; Liu, Tzu-An; Lin, Yan-Ren

doi:10.1016/j.ajem.2008.12.018

« Previous Next »American Journal of Emergency Medicine
Volume 28, Issue 3 , Pages 310-317, March 2010

Factors associated with sustained return of spontaneous circulation in children after out-of-hospital cardiac arrest of noncardiac origin

Chao-Jui Li, MD
- Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Chia-Te Kung, MD
- Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Ber-Ming Liu, MD
- Department of Emergency Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Chu-Chung Chou, MD
- Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Institute of Medicine, Chungshan Medical University, Taichung, Taiwan
Chin-Fu Chang, MD
- Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
Tung-Kung Wu, PhD
- Department of Biological Science and Technology and Institute of Biochemical Engineering, National Chiao Tung University, Hsinchu, Taiwan
Tzu-An Liu, PhD
- Department of Biological Science and Technology and Institute of Biochemical Engineering, National Chiao Tung University, Hsinchu, Taiwan
Yan-Ren Lin, MD
- Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department 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.

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.