The Pediatric Perioperative Cardiac Arrest (POCA) Registry

Abstract

The Pediatric Perioperative Cardiac Arrest (POCA) Registry was one of the first registries of its kind to generate an accurate incidence of perioperative cardiac arrest in pediatric patients undergoing surgery in the United States. This task was accomplished by collaboration with 62 medical centers including both academic institutions and community hospitals. While the POCA Registry faced some methodological challenges unique to the time it was created, it was able to answer important questions about factors associated with perioperative cardiac arrest in pediatric patients requiring anesthesia for surgery. POCA Registry data demonstrate that high American Society of Anesthesiologists physical status and emergency surgery were independent predictors of mortality from perioperative cardiac arrest, and that patients with congenital heart disease were at a significant and increased of perioperative cardiac arrest while undergoing noncardiac procedures. POCA Registry data also suggested that the use of halothane was particularly hazardous for infants. Future efforts to address perioperative cardiac arrest will benefit from utilization of electronic-based resources, although their widespread implementation is several years away.