Pediatric Cardiac Arrest Typically Due to Asystole

Survival after asystole higher in children than in adults

WEDNESDAY, Jan. 4 (HealthDay News) -- Cardiac arrest in children is typically due to asystole or pulseless electrical activity (PEA), and survival is better than in adults, according to a report in the Jan. 4 issue of the Journal of the American Medical Association.

Vinay M. Nadkarni, M.D., and others at the University of Pennsylvania in Philadelphia, conducted a prospective, observational study of cardiac arrest in 36,902 adults aged 18 and older and 880 children under the age of 18. The study period was Jan. 1, 2000 through Mar. 30, 2004.

The rate of survival to hospital discharge was 27% in children and 18% in adults. Of the survivors, 65% of children and 73% of adults had good neurological outcomes. Cardiac arrest from ventricular fibrillation or pulseless ventricular tachycardia occurred in 14% of children and 23% of adults, the study found. Asystole occurred in 40% of children and 35% of adults. The prevalence of PEA was 24% in children and 32% in adults.

The first documented pulseless arrest rhythm was the only factor significantly associated with survival to discharge in both children and adults with asystole or PEA.

Editorialist Linda Quan, M.D., of the University of Washington in Seattle, comments that whatever the cause of arrest or patient age, the approach is universal, and that is CPR and defibrillation. She writes "the pediatric chain of survival should be more like the adult chain of survival," with activation of EMS the first link.

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