Evaluation of cardiopulmonary resusitation when perforemed in a pediatric intensive care unit

Achieving success in CPR depends on many factors including age, underlying disease, daytime of and initiation of cardiopulmonary arrest and CPR, preparedness and availability of resuscitation teams. There are studies investigating the causes which concluded in many centers, risk factors and consequences of cardiopulmonary arrest in children. In this study, it was aimed to evaluate the characteristics of patients who underwent CPR in the pediatric intensive care unit. This retrospective study was conducted in Necmettin Erbakan University Pediatric Intensive Care Unit (PICU) between 20 September 2016-20 September 2022. All patients aged 0-18 years who underwent cardiopulmonary resuscitation in the PICU were included in the study. Age, gender, time of admission, endication for admission, underlying disease, duration of resuscitation, time of resuscitation, initial heart rhythm, administered drugs including adrenaline, noradrenaline, dopamine, dobutamine, calcium, sodium bicarbonate, number of saline doses obtained from the hospital database system and patient files , blood products, pH, lactate and bicarbonate values in blood gas amination were recorded and factors affecting the outcome of CPR were investigated. 200 patients who underwent CPR were included in the study. 41% were girls, 59% were boys, and the median age was 83 months. Cardiac arrest was present in 98% (n=196). The survival rate at discharge was 5.5%. The underlying diseases were neurological diseases in 42.3% (n=66), pulmonary diseases in 32.1% (n=50), and hematologic-oncological diseases in 24.4% (n=38) respectively. The reasons for admission to the PICU were pulmonary diseases (66.0%), cardiological diseases 11.0%, neurological diseases 11.0%, and nephrological diseases 5.5%, respectively. Compared to respiratory arrest, the prognosis was worse in cardiopulmonary arrests. There was no significant difference between day or night CPR and their final status. The median pH value of the patients with itus was 7.24, and the PCO2 values were found to be significantly higher than those of the living patients. However, PaO2, HCO3, Lactate values of patient with itus and surviving patients were found to be similar. The median resuscitation time of patients with itus was significant and higher than the patients who survived. No significant difference was found between the final status of the patients, their gender, and the presence of underlying disease (p=0.504; p=0.332, respectively). In this study, the rate of survival and discharge was found to be 5.5% in patients who underwent CPR in the PICU. Duration of resuscitation, presence of acidosis in blood gas, type of arrest are factors associated with survival.