Kathryn Best1, Myra H Wyckoff2, Rong Huang3, Ethan Sandford1, Noorjahan Ali4. 1. UT Southwestern Medical Center Department of Pediatrics Division of Critical Care Medicine, Dallas, TX, USA. 2. UT Southwestern Medical Center Department of Pediatrics Division of Neonatal-Perinatal Medicine, Dallas, TX, USA. 3. Children's Medical Center Dallas Department of Biostatistics, Dallas, TX, USA. 4. UT Southwestern Medical Center Department of Pediatrics Division of Neonatal-Perinatal Medicine, Dallas, TX, USA. Noorjahan.ali@utsouthwestern.edu.
Abstract
BACKGROUND: There is limited information on pulseless electrical activity (PEA)/asystolic cardiac arrest (CA) in the infant population. The aim is to describe the incidence and factors associated with outcomes in infants with PEA/asystolic CA. METHODS: Single-center retrospective chart review study of infants less than one year of age who suffer in-hospital PEA/asystolic CA from January 1 2011 to June 30 2019. The primary outcome was the return of spontaneous circulation. The secondary outcome was survival to discharge. RESULTS: CA occurred in 148 infants and PEA/asystolic was found in 38 (26%). Of those 29 (76%) achieved ROSC, and 12 (32%) survived to discharge. Infants on inotrope support or receiving longer duration of chest compressions and epinephrine had increase mortality. All infants with respiratory etiology of arrest survived to hospital discharge. CONCLUSION: PEA/asystolic CAs are uncommon. Poor prognostic indicators include the need for pre-arrest inotrope support and increased duration of chest compressions.
BACKGROUND: There is limited information on pulseless electrical activity (PEA)/asystolic cardiac arrest (CA) in the infant population. The aim is to describe the incidence and factors associated with outcomes in infants with PEA/asystolic CA. METHODS: Single-center retrospective chart review study of infants less than one year of age who suffer in-hospital PEA/asystolic CA from January 1 2011 to June 30 2019. The primary outcome was the return of spontaneous circulation. The secondary outcome was survival to discharge. RESULTS: CA occurred in 148 infants and PEA/asystolic was found in 38 (26%). Of those 29 (76%) achieved ROSC, and 12 (32%) survived to discharge. Infants on inotrope support or receiving longer duration of chest compressions and epinephrine had increase mortality. All infants with respiratory etiology of arrest survived to hospital discharge. CONCLUSION: PEA/asystolic CAs are uncommon. Poor prognostic indicators include the need for pre-arrest inotrope support and increased duration of chest compressions.
Authors: Alexis A Topjian; Tia T Raymond; Dianne Atkins; Melissa Chan; Jonathan P Duff; Benny L Joyner; Javier J Lasa; Eric J Lavonas; Arielle Levy; Melissa Mahgoub; Garth D Meckler; Kathryn E Roberts; Robert M Sutton; Stephen M Schexnayder Journal: Circulation Date: 2020-10-21 Impact factor: 29.690