Survival Measures after Cardiopulmonary Resuscitation and Related Factors among Children: Retrospective cohort Study in Iran Emergency

Background: Although cardiopulmonary resuscitation (CPR) is infrequently performed in paediatric emergencies, it is crucial that CPR is administered correctly and promptly for children requiring resuscitation. Objectives: This study aims to examine the demographic characteristics, etiological factors, and survival outcomes of patients who underwent CPR in the emergency department of the Children's Medical Center. Methods: In this Retrospective cohort study, we gathered data from ۱۴۹ resuscitated cases over a ۲-year period. all patients under ۱۸ years old who underwent CPR in the emergency department of the Children's Medical Center Hospital for any reason from April ۲۰۲۱ to March ۲۰۲۳ were retrospectively assessed. Demographic information and the information related to the factors causing resuscitation, underlying diseases, vital and clinical signs on arrival and resuscitation results were obtained by reviewing archived patient records. Results: The median age of patients was ۱۸.۰ months (IQR: ۶.۰-۷۰.۰) and ۵۱% were boys. ۶۴.۴% of patients achieved Return of Spontaneous Circulation, ۵۳.۷% survived for ۲۴ hours after the event, and ۲۴.۲% survived until discharge. The analysis of the association between contributing factors and survival measures in pediatric resuscitation efforts reveals several insights. The reason for resuscitation is an important factor, with respiratory arrest being strongly associated with better outcomes at all stages while cardiac and cardiopulmonary arrests show poorer prognoses (P- value۰.۰۰۱). The rhythm prior to chest compressions is also a significant predictor, with asystole and pulseless electrical activity (PEA) being associated with lower chances of ROSC and survivals (P-value ۰.۰۰۱). The location of the arrest is a pivotal factor, with in-hospital cardiac arrests (IHCA) showing better outcomes compared to out-of-hospital cardiac arrests (OHCA) (P-value۰.۰۰۱). Conclusions: In conclusion, this study underscores the critical importance of prompt and correct administration of cardiopulmonary resuscitation (CPR) in pediatric emergencies. These insights provide valuable guidance for improving resuscitation protocols and training programs to enhance survival rates in pediatric CPR scenarios.

کلیدواژه ها:

Cardiopulmonary Resuscitation ، Retrospective cohort Studies ، Survival