Factors influencing outcome of cardiopulmonary resuscitation in children

We evaluated 47 pediatric patients after cardiopulmonary arrest. Patients entered the study with the onset of advanced life support. We followed them until death, or discharge from the hospital, occurred. We identified three groups of patients: (1) long-term survivors, who survived to discharge, (2) short-term survivors, who survived longer than 24 hours after CPR but not until discharge, and (3) nonsurvivors, who died within 24 hours of their arrest. All of the long-term surviving patients were discharged from the hospital without gross neurologic deficit attributable to the arrest or resuscitation effort. Twenty-seven (57%) children were successfully resuscitated. Eighteen (38%) were long term-survivors, while nine (19%) were short-term survivors. Favorable outcome is associated with the following factors: (1) inhospital arrest, (2) extreme bradycardia as the presenting arrhythmia, (3) successful resuscitation with only ventilation, oxygen and closed chest massage, and (4) a duration of CPR of less than 15 minutes. Age, sex, and race, as well as pupillary reaction and motor response at the onset of advanced life support, did not correlate with long-term survival.