In-hospital pediatric cardiac arrest in Spain.
OBJECTIVE
The objective was to analyze the characteristics and prognostic factors of in-hospital pediatric cardiac arrest in Spain.


METHODS
A prospective observational study was performed to examine in-hospital pediatric cardiac arrest. Two hundred children were studied, aged between 1 month and 18 years, with in-hospital cardiac arrest. Univariate and multivariate logistic regression analyses were performed to assess the influence of each factor on survival to hospital discharge.


RESULTS
Return of spontaneous circulation was achieved in 74% of the patients and 41% survived to hospital discharge. The survival rate was significantly higher than that reported in a previous Spanish study 10 years earlier (25.9%). In the univariate analysis, the factors related to mortality were body weight higher than 10 kg; continuous infusion of vasoactive drugs prior to cardiac arrest; sepsis and neurological disorders as causes of cardiac arrest, the need for treatment with adrenaline, bicarbonate, and volume expansion, and prolonged cardiopulmonary resuscitation. In the multivariate analysis, the factors related to mortality were hematologic/oncologic diseases, continuous infusion of vasoactive drugs prior to cardiac arrest, cardiopulmonary resuscitation for more than 20 min, and treatment with bicarbonate and volume expansion.


CONCLUSIONS
Survival after in-hospital cardiac arrest in children has significantly improved in recent years. The factors related to in-hospital mortality were hematologic/oncologic diseases, continuous infusion of vasoactive drugs prior to cardiac arrest, the duration of cardiopulmonary resuscitation, and treatment with bicarbonate and volume expansion.
Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address: pielvi@hotmail.com.
Jesús
J
López-Herce
Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Jimena
J
del Castillo
Sección de Cuidados Intensivos Pediátricos, Hospital Vall d'Hebron, Barcelona, Spain.
Sonia
S
Cañadas
Servicio de Cuidados Intensivos Pediátricos y Urgencias, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain.
Antonio
A
Rodríguez-Núñez
Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Instituto de Investigación del Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Angel
A
Carrillo
D000293:Adolescent; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D005260:Female; D006323:Heart Arrest / Q000401:mortality*; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009369:Neoplasms / Q000453:epidemiology; D009422:Nervous System Diseases / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents
Cardiac arrest; Cardiopulmonary resuscitation; Children; Niños; Parada cardiaca; Reanimación; Reanimación cardiopulmonar; Resuscitation