Response to Letters Regarding Article, “Duration of Cardiopulmonary Resuscitation and Illness Category Impact Survival and Neurologic Outcomes for In-Hospital Pediatric Cardiac Arrests”

Abstract

We appreciate the interest of and insightful comments by Dr Joffe et al concerning the relationship between extracorporeal cardiopulmonary resuscitation (E-CPR) and in-hospital pediatric cardiac arrest outcomes. During the 10-year study period, only 227 of the 3419 patients received E-CPR, with very few patients in several illness categories.1 Although some E-CPR patients received shorter durations of CPR, 168 received E-CPR for >35 minutes. Of those who received >35 minutes of CPR, survival to hospital discharge was as follows: overall, 56 of 168 (33.3%); general surgical, 0 of 7 (0%); surgical cardiac, 40 of 104 (38.5%); medical cardiac, 15 of 34 (44.1%); general medical, 1 of 23 (4.4%); and trauma, 0 of 0. Survival to hospital discharge after >35 minutes of CPR without E-CPR was as follows: overall, 102 of 819 (12.5%); general surgical, 9 of 63 (14.3%); surgical cardiac, 26 of 156 (16.7%); medical cardiac, 22 of 145 (15.2%); general medical, 40 of 390 (10.3%); and trauma, 5 of 65 (7.7%). With the use of a 2-sided Fisher exact test (Stata 12.1) without adjustment for other potential confounding factors to compare those who received E-CPR …