Abstract

MORENO, Rodolfo P et al. Cardiopulmonaryresuscitation in nine pediatric intensive care units of the Argentine Republic. Arch. argent. pediatr. [online]. 2010, vol.108, n.3, pp.216-225. ISSN 0325-0075.

Introduction. The cardiopulmonary resuscitation (CPR) is a common settingin the pediatric intensive care unit (PICU). There are very few reports orpublications that evaluate the form of CPR administered in children.Objectives. 1) Identify the etiology and epidemiology of the CPRin the PICU. 2) Describe how to conduct CPR. 3) Describe the drugs used. 4)Knowing the patient outcomes. 5) Knowing CPR training of physicians in thePICU.Patients and methods. All children with cardiopulmonary arrestwho were resuscitated in the PICU between 01/04/2004- 31/03/2005. A prospectivecohort study.Results. There were 2065 admissions in nine 9 PICU and CPR wasconducted in 132 patients (6.39%). Most common etiologies of PCR were hypoxiaand hypotension (65.9% of total). The initial rates of PCR were 43.94%bradycardia, asystolia 43.18%, 9.85% ventricular arrhythmias. The averagebeginning of time of CPR was 0.08 minutes (SD 0.25) and the average totalduration was 25.91 minutes (SD 18.56). Patients who require drugs were 131. Thenumber (mean) dose of adrenaline was 4.03 (SD 2.78). Increased number of dosesof adrenaline was associated with less chance of recovery of spontaneouscirculation (ROSC), OR 0.48 95% CI 0.37-0.63. (p= 0.000). The duration of CPRwas inversely associated and significantly related to achieve ROSC, OR 0.93 95%CI 0.87-0.99. One hundred and four (78.79%) patients died and 28 survived. Allsurvived were discharged from PICU, but 26 from hospital. In 22 patients therewere not evidence of severe neurological damage when discharged home.Conclusions. Most common etiologies of PCR were hypoxia andshock. Most children received drugs. The drugs most used were the associationadrenaline-bicarbonate and adrenaline alone. The chances of recovery were notfavorable when CPR was conducted for over sixty minutes or more than six dosesof adrenaline were given, without response. CPR in PICU children has a highmortality. Most patients discharged from hospital, had neurological normalstate or slight disability. PICU physicians were highly trained in CPR withresuscitation courses.

Keywords : Cardiac arrest; Cardiopulmonary resuscitation; Pediatric intensive care unit; Intensive care.

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