OBJECTIVES: To characterize the association of hospital discharge survival with left ventricular systolic function evaluated by transthoracic echocardiography and vasoactive infusion support following return of spontaneous circulation after pediatric out-of-hospital cardiac arrest. DESIGN: Retrospective case series. SETTING: Single-center tertiary care pediatric cardiac arrest and critical care referral center. PATIENTS: Consecutive out-of-hospital cardiac arrest patients less than 18 years surviving to PICU admission who had a transthoracic echocardiography obtained by the clinical team within 24 hours of admission from January 2006 to May 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-eight patients had a post-return of spontaneous circulation transthoracic echocardiography performed within 24 hours of admission. The median time from return of spontaneous circulation to echo was 6.5 hours (interquartile range, 4.7, 15.0 hr). Left ventricular systolic function was decreased in 24 of 58 patients (41%). The mortality rate was 67% (39 of 58). Thirty-six patients (62%) received vasoactive infusions at the time of transthoracic echocardiography, and increased vasopressor inotropic score was associated with increased mortality on univariate analysis (p < 0.001). After controlling for defibrillation, vasopressor inotropic score, and interaction between vasopressor inotropic score and left ventricular systolic function, decreased left ventricular systolic function was associated with increased mortality (odds ratio, 13.7; 95% CI, 1.54-122). CONCLUSIONS: In patients receiving transthoracic echocardiography within the first 24 hours following return of spontaneous circulation after pediatric out-of-hospital cardiac arrest, decreased left ventricular systolic function and vasopressor use were common. Decreased left ventricular systolic function was associated with increased mortality.
OBJECTIVES: To characterize the association of hospital discharge survival with left ventricular systolic function evaluated by transthoracic echocardiography and vasoactive infusion support following return of spontaneous circulation after pediatric out-of-hospital cardiac arrest. DESIGN: Retrospective case series. SETTING: Single-center tertiary care pediatric cardiac arrest and critical care referral center. PATIENTS: Consecutive out-of-hospital cardiac arrestpatients less than 18 years surviving to PICU admission who had a transthoracic echocardiography obtained by the clinical team within 24 hours of admission from January 2006 to May 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-eight patients had a post-return of spontaneous circulation transthoracic echocardiography performed within 24 hours of admission. The median time from return of spontaneous circulation to echo was 6.5 hours (interquartile range, 4.7, 15.0 hr). Left ventricular systolic function was decreased in 24 of 58 patients (41%). The mortality rate was 67% (39 of 58). Thirty-six patients (62%) received vasoactive infusions at the time of transthoracic echocardiography, and increased vasopressor inotropic score was associated with increased mortality on univariate analysis (p < 0.001). After controlling for defibrillation, vasopressor inotropic score, and interaction between vasopressor inotropic score and left ventricular systolic function, decreased left ventricular systolic function was associated with increased mortality (odds ratio, 13.7; 95% CI, 1.54-122). CONCLUSIONS: In patients receiving transthoracic echocardiography within the first 24 hours following return of spontaneous circulation after pediatric out-of-hospital cardiac arrest, decreased left ventricular systolic function and vasopressor use were common. Decreased left ventricular systolic function was associated with increased mortality.
Authors: Robert W Neumar; Jerry P Nolan; Christophe Adrie; Mayuki Aibiki; Robert A Berg; Bernd W Böttiger; Clifton Callaway; Robert S B Clark; Romergryko G Geocadin; Edward C Jauch; Karl B Kern; Ivan Laurent; W T Longstreth; Raina M Merchant; Peter Morley; Laurie J Morrison; Vinay Nadkarni; Mary Ann Peberdy; Emanuel P Rivers; Antonio Rodriguez-Nunez; Frank W Sellke; Christian Spaulding; Kjetil Sunde; Terry Vanden Hoek Journal: Circulation Date: 2008-10-23 Impact factor: 29.690
Authors: Charmaine Childs; Andy Vail; Paul Leach; Timothy Rainey; Richard Protheroe; Andrew King Journal: Neurocrit Care Date: 2006 Impact factor: 3.210
Authors: Frank W Moler; Amy E Donaldson; Kathleen Meert; Richard J Brilli; Vinay Nadkarni; Donald H Shaffner; Charles L Schleien; Robert S B Clark; Heidi J Dalton; Kimberly Statler; Kelly S Tieves; Richard Hackbarth; Robert Pretzlaff; Elise W van der Jagt; Jose Pineda; Lynn Hernan; J Michael Dean Journal: Crit Care Med Date: 2011-01 Impact factor: 7.598
Authors: Dianne L Atkins; Siobhan Everson-Stewart; Gena K Sears; Mohamud Daya; Martin H Osmond; Craig R Warden; Robert A Berg Journal: Circulation Date: 2009-03-09 Impact factor: 29.690
Authors: Michael G Gaies; James G Gurney; Alberta H Yen; Michelle L Napoli; Robert J Gajarski; Richard G Ohye; John R Charpie; Jennifer C Hirsch Journal: Pediatr Crit Care Med Date: 2010-03 Impact factor: 3.624
Authors: Moritz Haugk; Christoph Testori; Fritz Sterz; Maximilian Uranitsch; Michael Holzer; Wilhelm Behringer; Harald Herkner Journal: Crit Care Date: 2011-03-25 Impact factor: 9.097
Authors: Allan R de Caen; Marc D Berg; Leon Chameides; Cheryl K Gooden; Robert W Hickey; Halden F Scott; Robert M Sutton; Janice A Tijssen; Alexis Topjian; Élise W van der Jagt; Stephen M Schexnayder; Ricardo A Samson Journal: Circulation Date: 2015-11-03 Impact factor: 29.690
Authors: Nicholas S Abend; Douglas J Wiebe; Rui Xiao; Shavonne L Massey; Mark Fitzgerald; France Fung; Alexis A Topjian Journal: J Clin Neurophysiol Date: 2018-05 Impact factor: 2.177
Authors: Robert M Sutton; Heather A Wolfe; Ron W Reeder; Tageldin Ahmed; Robert Bishop; Matthew Bochkoris; Candice Burns; J Wesley Diddle; Myke Federman; Richard Fernandez; Deborah Franzon; Aisha H Frazier; Stuart H Friess; Kathryn Graham; David Hehir; Christopher M Horvat; Leanna L Huard; William P Landis; Tensing Maa; Arushi Manga; Ryan W Morgan; Vinay M Nadkarni; Maryam Y Naim; Chella A Palmer; Carleen Schneiter; Matthew P Sharron; Ashley Siems; Neeraj Srivastava; Sarah Tabbutt; Bradley Tilford; Shirley Viteri; Robert A Berg; Michael J Bell; Joseph A Carcillo; Todd C Carpenter; J Michael Dean; Ericka L Fink; Mark Hall; Patrick S McQuillen; Kathleen L Meert; Peter M Mourani; Daniel Notterman; Murray M Pollack; Anil Sapru; David Wessel; Andrew R Yates; Athena F Zuppa Journal: JAMA Date: 2022-03-08 Impact factor: 157.335
Authors: Nicholas S Abend; Shavonne L Massey; Mark Fitzgerald; France Fung; Natalie J Atkin; Rui Xiao; Alexis A Topjian Journal: J Clin Neurophysiol Date: 2017-11 Impact factor: 2.177
Authors: Heather A Wolfe; Ryan W Morgan; Robert M Sutton; Ron W Reeder; Kathleen L Meert; Murray M Pollack; Andrew R Yates; John T Berger; Christopher J Newth; Joseph A Carcillo; Patrick S McQuillen; Rick E Harrison; Frank W Moler; Todd C Carpenter; Daniel A Notterman; J Michael Dean; Vinay M Nadkarni; Robert A Berg Journal: Resuscitation Date: 2020-07-01 Impact factor: 5.262
Authors: Monique M Gardner; Matthew P Kirschen; Hector R Wong; Daniel J McKeone; E Scott Halstead; Jill M Thompson; Adam S Himebauch; Alexis A Topjian; Nadir Yehya Journal: Resuscitation Date: 2021-12-03 Impact factor: 5.262
Authors: Ryan W Morgan; Matthew P Kirschen; Todd J Kilbaugh; Robert M Sutton; Alexis A Topjian Journal: JAMA Pediatr Date: 2021-03-01 Impact factor: 16.193