Appraisal of Pediatric Cardiopulmonary Resuscitation

Friesen RM, Duncan P, Tweed WA, Bristow G Canadian Medical Association Journal 1982 Pages 1055-1058

Sixty-six patients more than 30 days and less than 16 years of age suffering an unexpected cardiac arrest in Manitoba, Canada between July 1977 and December 1978 were studied. More than half the patients (36) were less than 1 year of age. Six children (9%) survived to be discharged from hospital. Another six patients survived more than 24 hours (mean 4.4 days) but were subsequently pronounced "brain dead". Respiratory disease accounted for most (29%) of the cardiac arrests, but it also had the most favourable prognosis, 21% of the 19 patients surviving. None of the patients survived whose cardiac arrest was secondary to sepsis or trauma, even when the resuscitative efforts were initially successful. Only 1/41 patients who had a cardiac arrest outside of hospital survived (given mouth-to-mouth resuscitation at home), and only 1/34 patients who presented with asystole survived, and then with considerable damage to the central nervous system. The interval between cardiac arrest and application of basic life support was substantially shorter among the survivors (2.3 mins for survivors vs. 6.5 minutes P<0.05) . Also, most of the survivors did not present with asystole. The results of this study suggest that survival among resuscitated children is no better than among adults but can be improved with early recognition and monitoring of children at risk, earlier application of basic and advanced life support, improved education of medical and lay personnel, and further research into pediatric resuscitative techniques.