title: Variability of characteristics and outcomes following cardiopulmonary resuscitation events in diverse ICU settings in a single, tertiary care children's hospital*.
abstract: OBJECTIVE
  The primary objective of this study was to compare and contrast the characteristics and survival outcomes of cardiopulmonary resuscitation for "monitored" events in pediatric patients treated with chest compressions more than or equal to 1 minute in varied ICU settings.
  
  
  METHODS
  Retrospective observational study.
  
  
  METHODS
  Three different specialized ICUs in a single, tertiary care, academic children's hospital.
  
  
  METHODS
  We collected demographic information, preexisting conditions, preevent characteristics, event characteristics, and outcome data. The primary outcome measure was survival to hospital discharge. Secondary outcome measures included return of spontaneous circulation, 24-hour survival, and survival with good neurologic outcome.
  
  
  METHODS
  None.
  
  
  RESULTS
  Four hundred eleven patients treated with chest compressions for more than or equal to 1 minute were included in the analysis: 170 patients were located in the cardiovascular ICU, 157 patients in the neonatal ICU, and 84 patients in the PICU. Arrest durations were longer in the cardiovascular ICU than other ICUs. Use of extracorporeal cardiopulmonary resuscitation was more prevalent in the cardiovascular ICU (cardiovascular ICU, 17%; neonatal ICU, 3%; PICU, 4%). Return of spontaneous circulation, 24-hour survival, survival to hospital discharge, and good neurologic outcome were highest among neonatal ICU patients (survival to discharge, 53%) followed by cardiovascular ICU patients (survival to discharge, 46%) and PICU patients (survival to discharge, 36%). In a multivariable model controlling for patient and event characteristics, using cardiovascular ICU as reference, adjusted odds of survival in PICU were 0.33 (95% CI, 0.14-0.76; p = 0.009) and odds of survival in neonatal ICU were 0.80 (95% CI, 0.31-2.11; p = 0.65).
  
  
  CONCLUSIONS
  Comparative analysis of pediatric patients undergoing cardiopulmonary resuscitation in three different ICU settings demonstrated a significant variation in baseline, preevent, and event characteristics. Although outcomes vary significantly among the three different ICUs, it was difficult to ascertain if this difference was due to variation in the disease process or variation in the location of the patient.
authors.affiliation: 1Divisions of Pediatric Cardiology and Critical Care, University of Arkansas Medical Center, Little Rock, AR. 2Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA. 3Department of Medical Education, Stanford University School of Medicine, Palo Alto, CA. 4Division of Biostatistics, Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock, AR. 5Department of Quality Management, Lucile Packard Children's Hospital, Palo Alto, CA. 6Division of Pediatric Critical Care, University School of Medicine, Palo Alto, CA. 7Division of Neonatal and Developmental Medicine, University School of Medicine, Palo Alto, CA. 8Department of Anesthesia and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Punkaj
authors.initials: P
authors.lastname: Gupta
authors.forename: Karen
authors.initials: K
authors.lastname: Yan
authors.forename: Vinca
authors.initials: V
authors.lastname: Chow
authors.forename: Duy T
authors.initials: DT
authors.lastname: Dao
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Gossett
authors.forename: Kit
authors.initials: K
authors.lastname: Leong
authors.forename: Deborah
authors.initials: D
authors.lastname: Franzon
authors.forename: Louis P
authors.initials: LP
authors.lastname: Halamek
authors.forename: Sushma
authors.initials: S
authors.lastname: Reddy
authors.forename: Robert A
authors.initials: RA
authors.lastname: Berg
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Roth
authors.forename: Vinay M
authors.initials: VM
authors.lastname: Nadkarni
mesh_terms: D000293:Adolescent; D016887:Cardiopulmonary Resuscitation / Q000401:mortality / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016019:Survival Analysis; D063128:Tertiary Health Care; D016896:Treatment Outcome