Abstract P-022: PREVALENCE AND OUTCOMES OF IN-HOSPITAL CARDIAC ARREST IN PEDIATRIC PATIENTS

Abstract

Aims & Objectives: The rates of pediatric in-hospital cardiac arrest (IHCS) are low, however, the survival to discharge rates are quite low with poor neurological outcomes. The objective of this study was to evaluate the related factors and survival rate in IHCA of pediatric patients who received cardiopulmonary resuscitation (CPR). Methods The retrospective study including pediatric patients aged 1 month to 18 years were diagnosed with cardiac arrest and receiving CPR in Ramathibodi hospital between January 2010 and December 2016. Descriptive analytic statistics and logistic regressions were used to analyze factors that related to the return of spontaneous circulation (ROSC) and survival. Results Total of admission were 32,122. Of 88 patients (0.27%) were enrolled. The overall sustained ROSC rate was 62.5% and the survival rate at discharge was 15.9%. The most common causes of IHCS were septic shock. Asphyxia-induced cardiac arrest accounted for 47% of patients receiving ROSC, compared with 21% of non-ROSC group (p = 0.01). By contrast, ischemic-induced cardiac arrest, which was the result of systemic circulatory shock from hypovolemia, sepsis, or myocardial dysfunction, was related to poor survival outcomes. Eighty percent of patients in non-ROSC group had hypotension before cardiac arrest, whereas there was only 51% of patients with hypotension from ROSC group (p = 0.005). Conclusions ROSC was associated with the causes of cardiac arrest. Patients who had hypotension as a pre-existing condition before cardiac arrest had poorer outcomes. On the contrary, asphyxia-induced cardiac arrest was significant factor related to achieving ROSC.