Epidemiology and outcomes of pediatric cardiac arrest in a cardiovascular unit at a public hospital in Argentina

Background: Cardiac arrest (CA) occurs in 2% of the children admitted to intensive care for non-cardiac diseases.In patients with heart disease, CA occurs in 2% to 16% according to different series reported.Objective: To describe the epidemiology and outcomes associated with pediatric cardiopulmonary resuscitation in a cardiovascular recovery unit.The primary endpoint was the survival to discharge and the secondary endpoints were the return to spontaneous circulation, the survival at 24 hours and the remote neurological condition.Methods: Descriptive, prospective, longitudinal cohort study in children under 18 years of age who required cardiopulmonary resuscitation between 2016 and 2019.Demographic variables, characteristics of cardiopulmonary arrest, resuscitation and outcome were analyzed.An uniand multivariate analysis was performed comparing survivors and deceased.Results: Out of 1,842 hospitalized patients, 4.1% presented CRA.Fifty patients with complete records were analyzed.Seventy-eight percent (39) returned to spontaneous circulation with a high survival rate of 46%.Resuscitation > 6 min and the use of vasoactive drugs were predictors of mortality; 16/23 patients were followed up, 10 of them with normal development for age at 6 months, six had pervasive developmental disorder.Conclusions: 4.1% of patients presented CRA, with a rate of 3.4 CRA per 1,000 patient-days.Survival at hospital discharge (n = 50) was 46%.Resuscitation > 6 min and the use of vasoactive drugs were independent predictors of mortality.At six months, 63% had normal neurological development for age.