Functional Status Change Among Children With Extracorporeal Membrane Oxygenation to Support Cardiopulmonary Resuscitation in a Pediatric Cardiac ICU

التفاصيل البيبلوغرافية
العنوان: Functional Status Change Among Children With Extracorporeal Membrane Oxygenation to Support Cardiopulmonary Resuscitation in a Pediatric Cardiac ICU
المؤلفون: Ryan P. Barbaro, Mathew R Baginski, Barry K Deatrick, Gabe E. Owens, Thomas J Johnson, Asaad G. Beshish
المصدر: Pediatric Critical Care Medicine. 19:665-671
بيانات النشر: Ovid Technologies (Wolters Kluwer Health), 2018.
سنة النشر: 2018
مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Adolescent, medicine.medical_treatment, 030204 cardiovascular system & hematology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, Extracorporeal Membrane Oxygenation, 0302 clinical medicine, Interquartile range, Hospital discharge, Extracorporeal membrane oxygenation, Humans, Medicine, Extracorporeal cardiopulmonary resuscitation, Cardiopulmonary resuscitation, Single institution, Child, Lactase, Retrospective Studies, business.industry, Infant, 030208 emergency & critical care medicine, Retrospective cohort study, Cardiopulmonary Resuscitation, Heart Arrest, Treatment Outcome, Child, Preschool, Pediatrics, Perinatology and Child Health, Emergency medicine, Female, Functional status, business
الوصف: Objectives The purpose of this study is to describe the functional status of survivors from extracorporeal cardiopulmonary resuscitation instituted during in-hospital cardiac arrest using the Functional Status Scale. We aimed to determine risk factors leading to the development of new morbidity and unfavorable functional outcomes. Design This was a single-center retrospective chart review abstracting patient characteristics/demographic data, duration of cardiopulmonary resuscitation, duration of extracorporeal membrane oxygenation support, as well as maximum lactate levels within 2 hours before and after extracorporeal cardiopulmonary resuscitation. Cardiac arrest was defined as the administration of chest compressions for a nonperfusing cardiac rhythm. Extracorporeal cardiopulmonary resuscitation was defined by instituting extracorporeal membrane oxygenation during active chest compressions. Functional Status Scale scores were calculated at admission and on hospital discharge for patients who survived. Setting Patients admitted in the pediatric cardiac ICU at C.S. Mott Children's Hospital from January 1, 2005, to December 31, 2015. Patients Children less than 18 years who underwent extracorporeal cardiopulmonary resuscitation. Interventions Not applicable. Measurements and main results Of 608 extracorporeal membrane oxygenation events during the study period, 80 were extracorporeal cardiopulmonary resuscitation (14%). There were 40 female patients (50%). Median age was 40 days (interquartile range, 9-342 d). Survival to hospital discharge was 48% (38/80). Median Functional Status Scale score at admission was 6 (interquartile range, 6-6) and at hospital discharge 9 (interquartile range, 8-11). Out of 38 survivors, 19 (50%) had a change of Functional Status Scale score greater than or equal to 3, that is consistent with new morbidity, and 26 (68%) had favorable functional outcomes with a change in Functional Status Scale score of less than 5. Conclusions This is the first extracorporeal cardiopulmonary resuscitation report to examine changes in Functional Status Scale from admission (baseline) to discharge as a measure of overall functional outcome. Half of surviving patients (19/38) had new morbidity, while 68% (26/38) had favorable outcomes. Lactate levels, duration of cardiopulmonary resuscitation, and duration of extracorporeal membrane oxygenation were not found to be risk factors for the development of new morbidity and poor functional outcomes. Functional Status Scale may be used as a metric to monitor improvement of extracorporeal cardiopulmonary resuscitation outcomes and help guide research initiatives to decrease morbidity in this patient population.
تدمد: 1529-7535
DOI: 10.1097/pcc.0000000000001555
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c56ab8fe134060c1d93897792dca2ab9
https://doi.org/10.1097/pcc.0000000000001555
رقم الانضمام: edsair.doi.dedup.....c56ab8fe134060c1d93897792dca2ab9
قاعدة البيانات: OpenAIRE
الوصف
تدمد:15297535
DOI:10.1097/pcc.0000000000001555