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CAUSES AND OUTCOMES OF TREATMENT FOR POST-OUT-OF-HOSPITAL CARDIAC ARREST IN CHILDREN AT THE VIETNAM NATIONAL CHILDREN'S HOSPITAL
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Abstract
Objectives: Describe the causes, clinical and paraclinical characteristics, and outcomes of out-of-hospital cardiac arrests in children. Subjects and methods: Describes a study of 36 pediatric patients with out-of-hospital cardiac arrests treated at the PICU (Pediatric Intensive Care Unit), National Children's Hospital, from June 2023 to March 2024. Results: The median age of patients was 4 years (IQR: 2 - 9 years). The ratio of boys is 3 times higher than girls. Situation occurred mainly in public places (72%) and with witnesses (88.9%). Most did not assess rhythm during initial cardiac arrest (69.4%). The most common causes were drowning (66.7%), cardiovascular causes 19.4%, respiratory causes 2.8%, and other causes 11.1%. Hospitalization status of pediatric patients: 86.1% of children had a return of spontaneous circulation, and 77.8% were intubated. However, the rate of low SpO2 < 94% accounted for 52.8%, low PaO2 < 60mmgHg was 37.5%, high PaCO2 >50mmHg was 18,2%; Hemodynamic status: 27.8% had systolic hypotension, median value of VIS score in the first 6 hours was 17.5 (IQR: 0-50), blood pH 7.29 mmol /l (IQR: 7.22-7.35 mmol/l); blood lactate 3.1 mmol/l (IQR: 1-5.7 mmol/l), glycemia 7.6 mmol/l (IQR: 5.7-11.6 mmol/l) and PRISM III score 14 (IQR: 10.3-25.8); Neurological status: 25% had seizures/hypertonia, 19.4% had dilated pupils > 3 mm and were unresponsive. The median duration of mechanical ventilation was 3.4 days (IQR: 0.8-7 days), and the PICU stay was 6 days (IQR: 1.5-11.7 days). The mortality rate was 27,8%. The survival rate with poor neurological outcomes was 38,9%. Conclusion: Pediatric patients with out-of-hospital cardiac arrests treated at the Department of PICU, National Children's Hospital, have the most common causes of drowning and cardiovascular disease. Post-cardiac arrest treatment goals related to respiratory, circulatory, and neurological aspects that were not well controlled before the moment of admission. The mortality rate and survival rate with severe neurological sequelae upon discharge from the hospital are still high
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Keywords
cardiac arrest, out of hospital, children.
References
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