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Pediatric survival rate after cardiac arrest increased threefold since 2000

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Survival rates after cardiac arrest have improved significantly in the past decade for critically-ill, hospitalized pediatric patients, according to a new report in Circulation: Cardiovascular Quality & Outcomes.

Researchers examined the cases of 1,031 children who experienced a cardiac arrest between 2000 and 2009 at12 urban US teaching hospitals participating in the American Heart Association’s Get With The Guidelines–Resuscitation program.

In 2009, 43% of the children studied survived until hospital discharge compared with 14% in 2000. Survival rates improved across all age groups, sexes and initial cardiac rhythm.

Among surviving children, risk for brain impairment remained unchanged, “suggesting an overall increase in the number of survivors without neurological disability over time,” the researchers said.

At the time of cardiac arrest, 84.4% of children had asytole or pulseless electrical activity and 15.2% had ventricular fibrillation or pulseless ventricular tachycardia. The researchers noted an increase in cardiac arrests due to pulseless electrical activity over time. Survival rates were lower among children with asystole or pulseless electrical activity.

“What was striking was that, despite this trend, survival still improved,” Saket Girotra, MD, an interventional cardiologist at the University of Iowa Hospitals and Clinics, said in a press release.

The researchers also explored whether enhanced survival rates were due to improved care during the resuscitation phase or post-resuscitation. Improvements during both phases were noted, with the biggest survival gains driven by improvement during the acute resuscitation phase (risk-adjusted rates: 42.9% in 2000 vs. 81.2% in 2009).

Although the study did not determine the mechanisms behind improved survival, Girotra said survival gains may be related to a combination of factors emphasized in the Get With The Guidelines–Resuscitation program, including early recognition of cardiac arrest through monitoring systems, high-quality chest compressions, timely defibrillations in patients with shockable heart rhythms, appropriate use of medicines during cardiac arrest and optimal care for resuscitated patients.

For more information:

Girotra S. CircCardiovasc Qual Outcomes. 2012:doi:10.1161/CIRCOUTCOMES.112.967968.

Disclosure:The Get With The Guidelines–Resuscitation program is sponsored by the AHA.