Clinical trial NCT06300710: Outcomes and Risk Factors of CPR in PICU
Official title: Outcome of Cardiopulmonary Resuscitation in Tertiary Level PICU and Associated Risk Factors
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Cardio Respiratory Arrest
Lead sponsor: Assiut University
Sponsor class: OTHER
First posted: 2024-03-08
Enrollment: 30
Sex: ALL
Minimum age (years): 1
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Observational model: CASE_ONLY
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Children aged from 1 month to 18 years who suffered in-PICU CA between March 2024 to February 2025 will be included. Cardiopulmonary arrest was defined as the presence of unresponsiveness, apnea, absence of signs of life, and absence of a palpable central pulse or bradycardia of \<60 bpm with poor perfusion in infants, requiring external cardiac compressions and assisted ventilation

Brief summary: 1. To detect the frequency and the underlying causes of cardiopulmonary arrest .
2. To detect outcome of CPR
3. To identify the associated risk factors for the different outcomes after CPR among those patients

Detailed description: Cardiac arrest (CA) is uncommon in children, and the epidemiology of pediatric CA is different from adults. CA Is a critical cause of death in children in the hospital especially in the pediatric Intensive care unit (PICU). CA Is reported in 2-6% of children in the PICU, which is much higher than out-of-hospital arrest (about 8 to 20 annual cases per 100,000 pediatric population .

Previous studies reported that return of spontaneous circulation (ROSC) after cardiopulmonary Resuscitation (CPR) for in-hospital CA (IHCA) is about half of these patients, and ∼30% survived to hospital discharge Previous studies had analyzed the cause and prognostic factors associated with outcomes after IHCA, which included the Initial rhythm, duration of CA and CPR, the underlying disease, and where the event attacked .

Patients in PICU are more likely to develop CA because they are more critically ill. Information on factors associated with prognosis of in-PICU CA can promote Improvement in PICU care, which means improving survival with good neurologic outcomes .

Analyzing the epidemiological variables and risk/prognostic factors of in-PICU CA is of great Importance in developing the better therapeutic strategy and deciding appropriate preventive Measure .

Probability of death on admission and a longer length Of stay in the PICU were associated with increased odds of receiving CPR. Children admitted with cardiac conditions were at significantly higher risk of receiving CPR in the PICU Compared with those Admitted with noncardiac primary diagnosis. The risk Of receiving CPR was significantly associated with age, History of preadmission CPR, also, Electrolyte Imbalances and Multi-organ Dysfunction increase risk of receiving CPR in PICU .

Eligibility criteria: Inclusion Criteria:

* Including Children aged 1 month to 18 years who received at least 1 minute of CPR

Exclusion Criteria:

* Exclusion of 1-Children aged below1 month and older than 18 years .
* terminal disease patients, such as malignancy

Primary outcomes:
measure: incidence of cardiac arrest and survival to discharge from the PICU (dead versus alive)
timeFrame: 1 year
Secondary outcomes:
measure: Rate of risk factors associated with outcome of CPR
timeFrame: 1 year
Other outcomes:
Locations:
Study officials:
References:
citation: Lee EP, Chan OW, Lin JJ, Hsia SH, Wu HP. Risk Factors and Neurologic Outcomes Associated With Resuscitation in the Pediatric Intensive Care Unit. Front Pediatr. 2022 Apr 4;10:834746. doi: 10.3389/fped.2022.834746. eCollection 2022.
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citation: Kuisma M, Suominen P, Korpela R. Paediatric out-of-hospital cardiac arrests--epidemiology and outcome. Resuscitation. 1995 Oct;30(2):141-50. doi: 10.1016/0300-9572(95)00888-z.
citation: Reis AG, Nadkarni V, Perondi MB, Grisi S, Berg RA. A prospective investigation into the epidemiology of in-hospital pediatric cardiopulmonary resuscitation using the international Utstein reporting style. Pediatrics. 2002 Feb;109(2):200-9. doi: 10.1542/peds.109.2.200.