Early Functional Status Change After Cardiopulmonary Resuscitation in a Pediatric Heart Center: A Single-Center Retrospective Study

• Published in: Pediatric cardiology Vol. 44; no. 8; pp. 1674 - 1683
• Main Authors: Batsis, Maria, Dryer, Rebecca, Scheel, Amy M., Basu, Mohua, Figueroa, Janet, Clarke, Shanelle, Shaw, Fawwaz R., Wolf, Michael J., Beshish, Asaad G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2023
• Subjects: Cardiac Surgery; Cardiology; Medicine; Medicine & Public Health; Vascular Surgery; Congenital heart disease; Functional status scale; New morbidity; Unfavorable outcome; Cardiac arrest
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-023-03251-5

Children with cardiac disease are at significantly higher risk for in-hospital cardiac arrest (CA) compared with those admitted without cardiac disease. CA occurs in 2–6% of patients admitted to a pediatric intensive care unit (ICU) and 4–6% of children admitted to the pediatric cardiac-ICU. Treatment of in-hospital CA with cardiopulmonary resuscitation (CPR) results in return of spontaneous circulation in 43–64% of patients and survival rate that varies from 20 to 51%. We aimed to investigate the change in functional status of survivors who experienced an in-hospital CA using the functional status scale (FSS) in our heart center by conducting a retrospective study of all patients 0–18 years who experienced CA between June 2015 and December 2020 in a free-standing university-affiliated quaternary children’s hospital. Of the 165 CA patients, 61% ( n  = 100) survived to hospital discharge. The non-survivors had longer length from admission to CA, higher serum lactate levels peri-CA, and received higher number of epinephrine doses. Using FSS, of the survivors, 26% developed new morbidity, and 9% developed unfavorable outcomes. There was an association of unfavorable outcomes with longer CICU-LOS and number of epinephrine doses given. Sixty-one-percent of CA patients survived to hospital discharge. Of the survivors, 26% developed new morbidity and 91% had favorable outcomes. Future multicenter studies are needed to help better identify modifiable risk factors for development of poor outcomes and help improve outcomes of this fragile patient population.