Utstein style reporting of in-hospital paediatric cardiopulmonary resuscitation
Introduction
Interpretation of outcome from paediatric resuscitation studies is complicated by the diverse aetiologies of cardiac arrest, the definition of cardiac arrest and CPR, age limits, and the level of prehospital and hospital care. Due to the low incidence of cardiac arrest in children, published studies are mainly retrospective and small.
The Utstein Style provides uniform guidelines for reporting advanced life support (ALS) research, and thus may improve patient care and outcome [1]. While several Utstein Style reports of adult cardiac arrest data are available, only one [2] focuses on paediatric cardiac arrest patients.
The purpose of the present study was to provide an Utstein style report of paediatric in-hospital cardiac arrest data and to evaluate factors associated with survival from cardiac arrest in hospitalized paediatric patients.
Section snippets
Patients and methods
The Hospital for Children and Adolescents (HCA) at Helsinki University Central Hospital is a 165-bed tertiary care teaching hospital in the capital of Finland. It has an eight-bed paediatric intensive care unit (PICU) which admits all critically ill children under 16 years of age in the area of southern Finland with roughly 1 310 000 inhabitants, except neurosurgical patients and children with severe trauma. The HCA is also nationally responsible for the care of paediatric patients requiring
Results
During the 5-year study period, 32 407 patients were admitted to the HCA (neonatal units excluded) for 163 648 hospital days. Of these patients, 3011 required PICU admission for 12 131 days. We identified 227 patients, who had sustained a cardiopulmonary arrest or received CPR for life-threatening hypotension or bradycardia. CPR was initiated in 118 (52.0%) of these patients, while 109 (48.0%) patients were declared dead without attempted resuscitation. In the non-CPR group 19 patients (17.4%)
Discussion
The Paediatric Utstein Style [1] enables comparison of survival rates from different institutions because it standardizes the reporting of patient data. To our knowledge, this study is the first Utstein-style report of in-hospital resuscitation data in children. Therefore, it is currently not possible to compare the incidence of CPR attempts and outcomes in the present study to earlier results, because the definitions of cardiac arrest and resuscitation vary. The incidence and outcome of CPR
Conclusions
The outcome of cardiopulmonary resuscitation in the Hospital for Children and Adolescents is in line with that in previous studies. Most CPR attempts took place in PICU and the most frequent etiology was cardiovascular. Short duration of external CPR was the best prognostic factor associated with survival of pediatric patients from in-hospital cardiac arrest. The Paediatric Utstein Style of reporting was easily applicable to pediatric arrest data, but compete data sets as suggested by the task
Acknowledgements
The authors would like to thank the staff from the archives of the Hospital for Adolescents and Children for their valuable assistance in obtaining the patients’ records. The authors are grateful to MD, PhD Olli Meretoja for his valuable comments on the manuscript.
References (22)
- et al.
Pediatric out-of-hospital cardiac arrests: Epidemiology and outcome
Resuscitation
(1995) - et al.
CPR in children
Ann. Emerg. Med.
(1987) - et al.
Future directions for resuscitation research. V. Ultra-advanced life support
Resuscitation
(1997) - et al.
Out-of-hospital ventricular fibrillation in children and adolescents: Causes and outcomes
Ann. Emerg. Med.
(1995) - et al.
Efficacy of cardiopulmonary resuscitation in pulseless paediatric trauma patients
Resuscitation
(1998) - et al.
Utstein style — a suggestion for revision. A statement by the Helsinki Cardiac arrest research team
Resuscitation
(1998) - AHA Medical/Scientific Statement. Recommended guidelines for uniform reporting of pediatric advanced life support: The...
- American Heart Association, Emergency Cardiac Care and Subcommittees. Guidelines for cardiopulmonary resuscitation and...
- et al.
Cardiopulmonary resuscitation in paediatric intensive care patients
Intensive Care Med.
(1992) - et al.
Cardiopulmonary resuscitation in a pediatric ICU
Crit. Care Med.
(1986)