Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country

Master Thesis

2015

Permanent link to this Item
http://hdl.handle.net/11427/16433
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thesis_hsf_2015_appiah_john_adabie (2).pdf (1.52 MB)
Authors
Appiah, John Adabie
Supervisors
Argent, Andrew
Salie, Shamiel
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Publisher
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University of Cape Town

Department
Department of Paediatrics and Child Health
Faculty
Faculty of Health Sciences
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Abstract
Objective: To describe the characteristics and outcomes of children admitted to PICU following cardiac arrest between January 2010 and December 2011. Methods: Retrospective descriptive study of routinely collected data. Results: Of 2501 PICU admissions, 110 (4.4%; 58.7% male) had preceding cardiac arrest, 80.6% of which occurred in hospital. Median (IQR) age was 7.2 (2.5 - 21.6) months; 30.8% had chronic underlying disease. Children presented most commonly with respiratory (n=28, 27.2%), cardiovascular (n= 22, 21.4%), and gastrointestinal disease (n= 20, 19.4%). Twenty-eight (27.2%) arrested while undergoing a procedure. Cardiopulmonary resuscitation (CPR) was given for median (IQR) 10 (5 - 20) minutes. Thirty-five (34%) patients received no adrenaline, 44 (42.7%) received up to 3 doses of adrenaline, and 24 (23.3%) received more than 3 doses of adrenaline during resuscitation. Duration of CPR and number of adrenaline doses did not significantly influence patient outcome. Survival to PICU discharge was 63 (61.2%), 57 (55.3%) survived to hospital discharge with half the deaths in PICU occurred within 24 hours of PICU admission. Out of 51 survivors whose neurological status were assessed 32 were normal, 6 had mild disability, 7 had moderate disability and 6 had severe disability. Standardized mortality ratio (actual/mean predicted) was 0.7. The median (IQR) length of stay in PICU and hospital were 3 (1 - 8) and 27 (9 -52) days respectively. Pediatric risk of mortality (PIM2) score was the only variable independently associated with mortality on multiple logistic regression (adjusted OR 1.05; 95% CI 1.02 - 1.07; p=0.0009).
Description

Includes bibliographical references

Keywords
Critical Care Paediatrics

Reference:

Appiah, J. 2015. Cardiac arrest in children preceding PICU admission: Aetiology and outcome in a developing country. University of Cape Town.

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