Abstract

Introduction: 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 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.

Keywords: Paediatric, Cardiopulmonary resuscitation, Outcomes, Survival.