Faculty Collaboration Database

Vasopressin for in-hospital pediatric cardiac arrest: results from the American Heart Association National Registry of Cardiopulmonary Resuscitation. Pediatr Crit Care Med 2009 Mar;10(2):191-5

Date

02/04/2009

Pubmed ID

19188873

DOI

10.1097/PCC.0b013e31819a36f2

Scopus ID

2-s2.0-68849092625 (requires institutional sign-in at Scopus site)   56 Citations

Abstract

OBJECTIVE: To describe the landscape of vasopressin uses reported to the American Heart Association National Registry of cardiopulmonary resuscitation (CPR) and test the hypothesis that vasopressin use will be associated with improved return of a sustained circulation (ROSC) following in-hospital pediatric cardiac arrest.

DESIGN: Multicentered, national registry of in-hospital CPR.

SETTING: One hundred seventy-six North American Hospitals reporting to registry from October 1999 to November 2004.

PATIENTS: Totally, 1293 consecutive pediatric patients with pulseless cardiac arrest meeting criteria for analysis identified from a registry of all patients resuscitated for cardiac arrest. Inclusion criteria were age <18 years, chest compressions and/or defibrillation, in-hospital location, and documented resuscitation record.

INTERVENTIONS: None.

MEASUREMENTS AND OUTCOMES: Prearrest, event, cardiopulmonary resuscitation, and postresuscitation variables were collected. Primary outcome variable was ROSC >20 minutes. Secondary survival outcomes included 24 hour, discharge and favorable neurologic survival on hospital discharge. Descriptive, univariate, and multivariable analysis to evaluate the association of vasopressin with survival outcomes were performed.

RESULTS: Only 5% of patients received vasopressin in this review. Vasopressin was most often given in a pediatric hospital (57%) and in and intensive care setting (76.6%). Patients who were given vasopressin had longer arrest duration (median 37 minutes) vs. those who did not (24 minutes) (p = 0.004). In multivariate analysis, vasopressin was associated with worse ROSC but no difference in 24 hours or discharge survival.

CONCLUSION: Vasopressin was given infrequently in in-hospital cardiac arrest. It was most likely to be given in an intensive care setting, and in a pediatric hospital. Multivariate analysis shows an association with vasopressin use and worse ROSC.

Author List

Duncan JM, Meaney P, Simpson P, Berg RA, Nadkarni V, Schexnayder S, National Registry of CPR Investigators

Author

Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
American Heart Association
Cardiopulmonary Resuscitation
Child
Child, Preschool
Education, Medical, Continuing
Female
Heart Arrest
Hospitals, Pediatric
Humans
Infant
Inpatients
Intensive Care Units
Male
Registries
Retrospective Studies
United States
Vasopressins