Study of Clinical Outcomes of Cardiopulmonary Resuscitation in Children
Journal of Medical Science And clinical Research
It was a prospective observational cross sectional study conducted in tertiary care center. Objective: To study the hemodynamics within 24 hours of initiation of cardiopulmonary resuscitation (CPR) and to compare the clinical & resuscitative parameters with the outcome post CPR. Method: Forty children aged 1 month to15 years who required CPR in hospital were included in the study. Neurological status was classified as neurologically intact, impaired or dependent. The cohort was divided into
... as divided into long-term survivors, short-term survivors and non-survivors. Results: Twenty four children required CPR for less than 15 minutes (60%) and 23/40 (57.5%) required resuscitation only once. Return of spontaneous circulation was seen in 35 patients (87.5%). Shorter duration and few attempts at CPR gave better chances of survival. Oliguria prior to CPR led to significantly poor outcomes. Prolonged ventilation (>7days) was directly related to worse neurological impairment and dependency (p=0.00054). Out of 40, 7 patients (17.5%) were non-survivors, 8 (20%) were short-term survivors and 25 (62.5%) were labeled as long-term survivors. Of 25 patients who survived till discharged 17 (68%) were neurologically normal, 3 (12%) had some functional neurological impairment. Conclusions: Eighty two percent children survived post CPR with 68% having a normal neurological status on discharge. Shorter duration and fewer attempts of CPR, higher motor response post CPR and early institution of enteral feeds had a favorable impact on survival outcome. Oliguria, increased fluid requirement, hyponatremia, hyperglycemia, hypoxia and hypocarbia in the peri-resuscitation period were unfavorable factors for survival. Prolonged ventilator support correlated with poorer neurological outcome.