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

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Abstract

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.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Cardiology, Emory University School of Medicine, Children’s Healthcare of Atlanta, 2835 Brandywine Road, suite 400, Atlanta, GA, 30341, USA

    Maria Batsis, Shanelle Clarke, Michael J. Wolf & Asaad G. Beshish

  2. Emory University School of Medicine, Atlanta, GA, USA

    Rebecca Dryer & Amy M. Scheel

  3. Qualitative Analysis, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Mohua Basu

  4. Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Janet Figueroa

  5. Department of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Fawwaz R. Shaw

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  1. Maria Batsis
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  2. Rebecca Dryer
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  3. Amy M. Scheel
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  4. Mohua Basu
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  8. Michael J. Wolf
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  9. Asaad G. Beshish
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by MB, RD, AMS, MB, JF, and AGB. The first draft of the manuscript was written by MB and AGB. All authors commented on various versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Asaad G. Beshish.

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Batsis, M., Dryer, R., Scheel, A.M. et al. Early Functional Status Change After Cardiopulmonary Resuscitation in a Pediatric Heart Center: A Single-Center Retrospective Study. Pediatr Cardiol 44, 1674–1683 (2023). https://doi.org/10.1007/s00246-023-03251-5

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  • DOI: https://doi.org/10.1007/s00246-023-03251-5

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