Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

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  • Matsui Satoshi
    Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine Department of Emergency and General Medicine, Hyogo Prefectural Kobe Children's Hospital
  • Sobue Tomotaka
    Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine
  • Irisawa Taro
    Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
  • Yamada Tomoki
    Emergency and Critical Care Medical Center, Osaka Police Hospital
  • Hayakawa Koichi
    Department of Emergency and Critical Care Medicine, Kansai Medical University, Takii Hospital
  • Yoshiya Kazuhisa
    Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
  • Noguchi Kazuo
    Department of Emergency Medicine, Tane General Hospital
  • Nishimura Tetsuro
    Department of Critical Care Medicine, Osaka City University
  • Ishibe Takuya
    Department of Emergency and Critical Care Medicine, Kindai University Faculty of Medicine
  • Yagi Yoshiki
    Osaka Mishima Emergency Critical Care Center
  • Kiguchi Takeyuki
    Kyoto University Health Services Critical Care and Trauma Center, Osaka General Medical Center
  • Kishimoto Masafumi
    Osaka Prefectural Nakakawachi Medical Center of Acute Medicine
  • Shintani Hiroshi
    Senshu Trauma and Critical Care Center
  • Hayashi Yasuyuki
    Senri Critical Care Medical Center, Saiseikai Senri Hospital
  • Sogabe Taku
    Traumatology and Critical Care Medical Center, National Hospital Organization Osaka National Hospital
  • Morooka Takaya
    Emergency and Critical Care Medical Center, Osaka City General Hospital
  • Sakamoto Haruko
    Department of Pediatrics, Osaka Red Cross Hospital
  • Suzuki Keitaro
    Emergency and Critical Care Medical Center, Kishiwada Tokushukai Hospital
  • Nakamura Fumiko
    Department of Emergency and Critical Care Medicine, Kansai Medical University, Hirakata
  • Nishioka Norihiro
    Department of Preventive Services, Kyoto University School of Public Health
  • Okada Yohei
    Department of Preventive Services, Kyoto University School of Public Health
  • Matsuyama Tasuku
    Department of Emergency Medicine, Kyoto Prefectural University of Medicine
  • Sado Junya
    Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine
  • Shimazu Takeshi
    Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
  • Tanaka Ryojiro
    Department of Emergency and General Medicine, Hyogo Prefectural Kobe Children's Hospital
  • Kurosawa Hiroshi
    Division of Pediatric Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital
  • Iwami Taku
    Kyoto University Health Services
  • Kitamura Tetsuhisa
    Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine
  • on behalf of the CRITICAL Study Group Investigators

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  • A Multicenter, Prospective Registry in Osaka, Japan

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<p>The effect of post-cardiac arrest care in children with out-of-hospital cardiac arrest (OHCA) has not been adequately established, and the long-term outcome after pediatric OHCA has not been sufficiently investigated. We describe here detailed in-hospital characteristics, actual management, and survival, including neurological status, 90 days after OHCA occurrence in children with OHCA transported to critical care medical centers (CCMCs).</p><p>We analyzed the database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITICAL) study, which is a multicenter, prospective observational data registry designed to accumulate both pre- and in-hospital data on OHCA treatments. We enrolled all consecutive pediatric patients aged <18 years who had an OHCA and for whom resuscitation was attempted and who were transported to CCMCs between 2012 and 2016.</p><p>A total of 263 pediatric patients with OHCA were enrolled. The average age of the patients was 6.3 years, 38.0% were aged < 1 year, and 60.8% were male. After hospital arrival, 4.9% of these pediatric patients received defibrillation; 1.9%, extracorporeal life support; 6.5%, target temperature management; and 88.2% adrenaline administration. The proportions of patients with 90-day survival and a pediatric cerebral performance category (PCPC) score of 1 or 2 were 6.1% and 1.9%, respectively. The proportion of patients with a PCPC score of 1 or 2 at 90 days after OHCA occurrence did not significantly improve during the study period.</p><p>The proportion of pediatric patients with a 90-day PCPC score of 1 or 2 transported to CCMCs was extremely low, and no significant improvements were observed during the study period.</p>

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