RT info:eu-repo/semantics/article
T1 Pediatric defibrillation after cardiac arrest: Initial response and outcome
A1 Rodríguez-Núñez, Antonio
A1 López-Herce Cid, Jesús
A1 García, Cristina
A1 Domínguez Sampedro, Pedro
A1 Carrillo, Ángel
A1 Bellón Cano, José María
K1 Pediatric defibrillation
K1 Cardiac arrest
K1 Cirugía
K1 Surgery
K1 Ciencias de la salud
K1 Health sciences
AB Introduction Shockable rhythms are rare in pediatric cardiacarrest and the results of defibrillation are uncertain. Theobjective of this study was to analyze the results ofcardiopulmonary resuscitation that included defibrillation inchildren.Methods Forty-four out of 241 children (18.2%) who wereresuscitated from inhospital or out-of-hospital cardiac arrest hadbeen treated with manual defibrillation. Data were recordedaccording to the Utstein style. Outcome variables were asustained return of spontaneous circulation (ROSC) and oneyearsurvival. Characteristics of patients and of resuscitationwere evaluated.Results Cardiac disease was the major cause of arrest in thisgroup. Ventricular fibrillation (VF) or pulseless ventriculartachycardia (PVT) was the first documented electrocardiogramrhythm in 19 patients (43.2%). A shockable rhythm developedduring resuscitation in 25 patients (56.8%). The first shock(dose, 2 J/kg) terminated VF or PVT in eight patients (18.1%).Seventeen children (38.6%) needed more than three shocks tosolve VF or PVT. ROSC was achieved in 28 cases (63.6%) andit was sustained in 19 patients (43.2%). Only three patients(6.8%), however, survived at 1-year follow-up. Children with VFor PVT as the first documented rhythm had better ROSC, betterinitial survival and better final survival than children withsubsequent VF or PVT. Children who survived were older thanthe finally dead patients. No significant differences in responserate were observed when first and second shocks werecompared. The survival rate was higher in patients treated witha second shock dose of 2 J/kg than in those who receivedhigher doses. Outcome was not related to the cause or thelocation of arrest. The survival rate was inversely related to theduration of cardiopulmonary resuscitation.Conclusion Defibrillation is necessary in 18% of children whosuffer cardiac arrest. Termination of VF or PVT after the firstdefibrillation dose is achieved in a low percentage of cases.Despite a sustained ROSC being obtained in more than onethirdof cases, the final survival remains low. The outcome is verypoor when a shockable rhythm develops during resuscitationefforts. New studies are needed to ascertain whether the newinternational guidelines will contribute to improve the outcomeof pediatric cardiac arrest.
PB BioMed Central
SN 1364-8535
YR 2006
FD 2006
LK http://hdl.handle.net/10017/6720
UL http://hdl.handle.net/10017/6720
LA eng
NO This study was supported by a Grant from the Fondo de InvestigacionesSanitarias, 00/0288.
DS MINDS@UW
RD 19-abr-2024