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Abstract PD-001: PROGNOSTIC FACTORS FOR SURVIVAL POST CARDIAC ARREST IN KIDS THE NETPACK-2 AUDIT

Evans, S.1; Martin, J.2; Kapetanstrataki, M.3; Parslow, R.C.3; Scholefield, B.1,4

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 26
doi: 10.1097/01.pcc.0000537403.85601.40
Poster Discussion Abstracts
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1Birmingham Women and Children’s Hospital NHS Foundation Trust, Paediatric Intensive Care, Birmingham, United Kingdom

2University of Birmingham, Institute of Applied Health Research, Birmingham, United Kingdom

3University of Leeds, Leeds Institute of Cardiovascular and Metabolic Medicine- School of Medicine, Leeds, United Kingdom

4University of Birmingham, Institute of Inflammation and Ageing, Birmingham, United Kingdom

Received April 4, 2018

Accepted April 4, 2018

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Aims & Objectives:

Paediatric cardiac arrest (CA) is associated with high mortality and morbidity. Despite significant advances in post-arrest intensive care, it is unclear who will benefit from invasive interventions and considerable prognostic uncertainty remains. We therefore aimed to identify prognostic factors in order to inform survival prediction within 1 hour after admission to paediatric intensive care units (PICU).

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Methods

We used data prospectively collected as part of the Paediatric Intensive Care Audit Network (PICANet) on children admitted to PICU after CA in 23 PICUs in the UK and Republic of Ireland (August 2014- December 2015). Inclusion criteria were admission after >2 minutes of cardiopulmonary resuscitation and mechanical ventilation. We excluded CA within the PICU. Outcome was in-PICU mortality. Patient demographics, arrest characteristics and resuscitation interventions were included in a multivariable logistic regression analysis. Multiple imputation was performed for missing data.

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Results

313 patients were included, 64% were male. Median age was 1 year [IQR: 3 months – 7 years]. 156 (49.8 %) patients had in-hospital and 157 (50.2%) out-of-hospital CA. After adjustment for location of CA, factors associated with increased mortality were: blood lactate, female sex, requirement for vasoactive infusion, neurological co-morbidity, pupil reactivity to light, and secondary hospital transport for admission into a PICU (see table 1).

Table

Table

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Conclusions

Identified prognostic factors provide additional information for clinicians and families on expectation of survival after CA. The association of inter-hospital transfer on survival may be a target for quality improvement initiatives. Further model development and validation is required.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies