Significant factors in predicting sustained ROSC in paediatric patients with traumatic out-of-hospital cardiac arrest admitted to the emergency department

Yan Ren Lin, Han Ping Wu*, Chin Yi Huang, Yu Jun Chang, Ching Yuang Lin, Chu Chung Chou

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

31 Scopus citations

Abstract

Background: Paediatric patients with out-of-hospital cardiac arrest (OHCA) due to trauma pose difficult challenges in resuscitation. Trauma is a major cause of OHCA in children. The aim of this study was to determine which factors were related to predicting a sustained return of spontaneous circulation (ROSC) in paediatric OHCA patients with trauma. Method: This retrospective study comprised 115 paediatric patients (56 traumatic and 59 non-traumatic OHCA patients) aged younger than 18 years who had been admitted to the emergency department (ED) from January 2000 to December 2004. We analysed the demographic data and the factors that may have influenced sustained ROSC in the group of OHCA paediatric patients with trauma. The non-trauma group was established as a control group. Survival analysis was used to compare differences in survival rate between trauma and non-trauma OHCA patients. Receiver operating characteristic (ROC) analysis was used to determine the significant in-hospital CPR duration related to sustained ROSC. Results: Initial cardiac rhythm on arrival (P = 0.005) and the duration of in-hospital CPR (P < 0.001) were significant factors. Patients with PEA or VF had higher rate of sustained ROSC than those with asystole (PEA: P = 0.003, VF: P = 0.03). In the survival analysis, OHCA children with trauma had a lower chance of survival than non-trauma children as the interval from the scene to the ER increased (P = 0.008). Based on the ROC analysis, the cut-off values of in-hospital CPR duration were 25 min in OHCA paediatric patients with trauma. Conclusion: Several significant factors relating to sustained ROSC were determined in the OHCA paediatric patients with trauma; most importantly, we found that in-hospital CPR may have to be performed for at least 25 min to enable a spontaneous circulation to return.

Original languageEnglish
Pages (from-to)83-89
Number of pages7
JournalResuscitation
Volume74
Issue number1
DOIs
StatePublished - 07 2007
Externally publishedYes

Keywords

  • Out-of-hospital cardiac arrest
  • Paediatric
  • Predict
  • Sustained ROSC

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