Effect and influence factors of cardiopulmonary resuscitation in children with congenital heart disease in pediatric intensive care unit.
10.3760/cma.j.cn112140-20211116-00962
- Author:
Gang LIU
1
;
Jian Ping CHU
2
;
Jian Li CHEN
3
;
Su Yun QIAN
1
;
Dan Qun JIN
4
;
Xiu Lan LU
5
;
Mei Xian XU
6
;
Yi Bing CHENG
7
;
Zheng Yun SUN
8
;
Hong Jun MIAO
9
;
Jun LI
10
;
Sheng Ying DONG
11
;
Xin DING
1
;
Ying WANG
2
;
Qing CHEN
3
;
Yuan Yuan DUAN
4
;
Jiao Tian HUANG
5
;
Yan Mei GUO
6
;
Xiao Na SHI
6
;
Jun SU
7
;
Yi YIN
8
;
Xiao Wei XIN
8
;
Shao Dong ZHAO
9
;
Zi Xuan LOU
10
;
Jing Hui JIANG
11
;
Jian Sheng ZENG
1
Author Information
1. Pediatric Intensive Care Unit,Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China.
2. Pediatric Intensive Care Unit, Xian Children's Hospital, Xi'an 710003, China.
3. Pediatric Intensive Care Unit, Guiyang Maternal and Child Health Care Hospital, Guiyang 550000, China.
4. Pediatric Intensive Care Unit, Anhui Children's Hospital, Hefei 230000, China.
5. Pediatric Intensive Care Unit, Children's Hospital of Hunan Province, Changsha 410000, China.
6. Pediatric Intensive Care Unit, Hebei Children's Hospital, Shijiazhuang 050000, China.
7. Pediatric Intensive Care Unit, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China.
8. Pediatric Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, China.
9. Emergency Ward/Pediatric Intensive Care Unit, Children's Hospital of Nanjing Medical University, Nanjing 210000, China.
10. Pediatric Intensive Care Unit, Jinan Children's Hospital, Jinan 250000, China.
11. Pediatric Intensive Care Unit, Liaocheng People's Hospital, Liaocheng 252000, China.
- Publication Type:Multicenter Study
- MeSH:
Cardiopulmonary Resuscitation;
Child;
Child, Preschool;
Female;
Heart Arrest/therapy*;
Heart Defects, Congenital/therapy*;
Humans;
Intensive Care Units, Pediatric;
Male;
Retrospective Studies
- From:
Chinese Journal of Pediatrics
2022;60(3):197-202
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the prognostic factors of children with congenital heart disease (CHD) who had undergone cardiopulmonary resuscitation (CPR) in pediatric intensive care unit (PICU) in China. Methods: From November 2017 to October 2018, this retrospective multi-center study was conducted in 11 hospitals in China. It contained data from 281 cases who had undergone CPR and all of the subjects were divided into CHD group and non-CHD group. The general condition, duration of CPR, epinephrine doses during resuscitation, recovery of spontaneous circulation (ROSC), discharge survival rate and pediatric cerebral performance category in viable children at discharge were compared. According to whether malignant arrhythmia is the direct cause of cardiopulmonary arrest or not, children in CHD and non-CHD groups were divided into 2 subgroups: arrhythmia and non-arrhythmia, and the ROSC and survival rate to discharge were compared. Data in both groups were analyzed by t-test, chi-square analysis or ANOVA, and logistic regression were used to analyze the prognostic factors for ROSC and survival to discharge after cardiac arrest (CA). Results: The incidence of CA in PICU was 3.2% (372/11 588), and the implementation rate of CPR was 75.5% (281/372). There were 144 males and 137 females with median age of 32.8 (5.6, 42.7) months in all 281 CPA cases who received CPR. CHD group had 56 cases while non-CHD had 225 cases, with the percentage of 19.9% (56/281) and 80.1% (225/281) respectively. The proportion of female in CHD group was 60.7% (34/56) which was higher than that in non-CHD group (45.8%, 103/225) (χ2=4.00, P=0.045). There were no differences in ROSC and rate of survival to discharge between the two groups (P>0.05). The ROSC rate of children with arthythmid in CHD group was 70.0% (28/40), higher than 6/16 for non-arrhythmic children (χ2=5.06, P=0.024). At discharge, the pediatric cerebral performance category scores (1-3 scores) of CHD and non-CHD child were 50.9% (26/51) and 44.9% (92/205) respectively. Logistic regression analysis indicated that the independent prognostic factors of ROSC and survival to discharge in children with CHD were CPR duration (odds ratio (OR)=0.95, 0.97; 95%CI: 0.92~0.97, 0.95~0.99; both P<0.05) and epinephrine dosage (OR=0.87 and 0.79, 95%CI: 0.76-1.00 and 0.69-0.89, respectively; both P<0.05). Conclusions: There is no difference between CHD and non-CHD children in ROSC and survival rate of survival to discharge was low. The epinephrine dosage and the duration of CPR are related to the ROSC and survival to discharge of children with CHD.
