Factors affected outcome of cardiopulmonary resuscitation in children

Objectives: Successfull cardiopulmonary resuscitation depends on many conditions such as age, underlying disease, the time between cardiopulmonary arrest and cardiopulmonary resuscitation, availability of equipment. There are limited studies evaluating causes, risk factors and results of cardiopulmonary arrest among children. In this study we aim to evaluate the factors which may affect outcome of cardiopulmonary resuscitation in emergency department. Material and Method: This retrospective study performed between Jan 2009 and July 2013 in Dokuz Eylül University pediatric emergency service. It includes all patients under 18 who were administered cardiopulmonary resuscitation. The informations such as age, sex, application time, presence of trauma, underlying diseases, resuscitation period, initial heart rythm, administrated adrenalin and bicarbonate dosage, blood glucose, pH , lactate and bicarbonate values in blood gas were collected from database of hospital system and evaluate the factors which may affect outcome of cardiopulmonary resuscitation. Results: 107 patients who were administrated cardiopulmonary resuscitation participated in this study. Male/female ratio was 1.3 and mean age was 42 months (1 day-209 month) 63 patient with respiratory arrest (59%) and 44 patient with cardiopulmonary arrest(41%) were included. Survival rate was 36.4% percent. The underlying reasons for non traumatic cases were respiratory, neurologic and cardiovascular diseases per se whereas in traumatic cases the most common reasons were motor vehicle accidents. Survival in respiratory arrest was higher than survival in cardiopulmonary arrest (p<0,05). The highest survival rate was observed in the initial rhythm in patients with sinus rhythm (p<0,01). Survival in discharge of hospital has negative correlation with duration of cardiopulmonary resuscitation and lactate levels in blood gas. Conclusions: In this study, rate of survival at discharge was found 36,4% percent. Duration of cardiopulmonary resuscitation, initial heart rythm, acidosis in blood gas and and lactate levels are relevant to survival.