[Cardiorespiratory arrest in children with trauma].
OBJECTIVE
To analyze the characteristics and outcome of cardiorespiratory arrest secondary to trauma in children.


METHODS
We performed a secondary analysis of data from a prospective, multicenter study of cardiorespiratory arrest in children. Data were recorded according to the Utstein style. Twenty-eight children (age range: 7 days to 16 years) with cardiorespiratory arrest secondary to trauma were evaluated. The outcome variables were return of spontaneous circulation, sustained (more than 20 minutes) return of spontaneous circulation (initial survival), and survival at hospital discharge (final survival) in relation to the characteristics of the cardiorespiratory arrest and cardiopulmonary resuscitation. Neurological and general performance outcome was assessed by means of the Pediatric Cerebral Performance Category scale and the Pediatric Overall Performance Category scale.


RESULTS
Return of spontaneous circulation was obtained in 18 patients (64.2 %), initial survival was achieved in 14 (50 %) and final survival was achieved in three (10.7 %) (two without neurological sequelae and one with vegetative status). Final survival was significantly higher in patients with respiratory arrest (33.3 %) than in those with cardiac arrest (4.5 %), p = 0.04. Final survival was also higher in patients with a duration of cardiopulmonary resuscitation shorter than 20 minutes (27.2 %) than in the remaining patients (0 %), p =0.05. The two survivors without neurologic sequelae had respiratory arrest.


CONCLUSIONS
Survival until hospital discharge in children with cardiorespiratory arrest secondary to trauma is lower than that in children with cardiorespiratory arrest. Patients with respiratory arrest when resuscitation is started and those with a duration of cardiopulmonary resuscitation of less than 20 minutes showed better survival than the remaining patients.
López-Herce Cid
J
J
Sección de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Madrid, España. pielvi@ya.com
Domínguez Sampedro
P
P
Rodríguez Núñez
A
A
García Sanz
C
C
Carrillo Alvarez
A
A
Calvo Macías
C
C
Bellón Cano
J M
JM
D000293:Adolescent; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D002534:Hypoxia, Brain / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications*