Logo image
Back
Association of blood pressure with neurologic outcome at hospital discharge after pediatric cardiac arrest resuscitation
Journal article   Peer reviewed

Association of blood pressure with neurologic outcome at hospital discharge after pediatric cardiac arrest resuscitation

A. Ushpol, S. Je, D. Niles, T. Majmudar, M. Kirschen, J. del Castillo, C. Buysse, A. Topjian, V. Nadkarni, S. Gangadharan, …
Resuscitation, v 194, 110066
01 Jan 2024
DOI: https://doi.org/10.1016/j.resuscitation.2023.110066
PMID: 38056760
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Blood pressure Cardiopulmonary resuscitation Hypotension Outcomes Post-cardiac arrest Pediatrics
Background: Poor outcomes are associated with post cardiac arrest blood pressures <5th percentile for age. We aimed to study the relationship of mean arterial pressure (MAP) with favorable neurologic outcome following cardiac arrest and return of spontaneous circulation (ROSC). Methods: This retrospective, multi-center, observational study analyzed data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q). Children (<18 years) who achieved ROSC following index in-hospital or out-of-hospital cardiac arrest and survived ≥6 hours were included. Lowest documented MAP within the first 6 hours of ROSC was percentile adjusted for age and categorized into six groups – Group I: <5th, II: 5–24th, III: 25–49th, IV: 50–74th, V: 75–94th; and VI: 95–100th percentile. Primary outcome was favorable neurologic status at hospital discharge, defined as PCPC score 1, 2, or no change from pre-arrest baseline. Multivariable logistic regression was performed to analyze the association of MAP group with favorable outcome, controlling for illness category (surgical-cardiac), initial rhythm (shockable), arrest time (weekend or overnight), age, CPR duration, and clustering by site. Results: 787 patients were included: median [Q1,Q3] age 17.9 [4.8,90.6] months; male 58%; OHCA 21%; shockable rhythm 13%; CPR duration 7 [3,16] min; favorable neurologic outcome 54%. Median lowest documented MAP percentile for the favorable outcome group was 13 [3,43] versus 8 [1,37] for the unfavorable group. The distribution of blood pressures by MAP group was I: 37%, II: 28%, III: 13%, IV: 11%, V: 7%, and VI: 4%. Compared with patients in Group I (<5%ile), Groups II, III, and IV had higher odds of favorable outcome (aOR, 1.84 [95% CI, 1.24, 2.73]; 2.20 [95% CI, 1.32, 3.68]; 1.90 [95% CI, 1.12, 3.25]). There was no association between Groups V or VI and favorable outcome (aOR, 1.44 [95% CI, 0.75, 2.80]; 1.11 [95% CI, 0.47, 2.59]). Conclusion: In the first 6-hours post-ROSC, a lowest documented MAP between the 5th−74th percentile for age was associated with favorable neurologic outcome compared to MAP <5th percentile for age.

Metrics

1 Record Views
15 citations in Web of Science

Details

UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

Source: SDGs in the Output

InCites Highlights

Data related to this publication, from InCites Benchmarking & Analytics tool:

Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Critical Care Medicine
Emergency Medicine
Logo image