CPR Duration and Outcome in Children

Circulation 2013 - Epub on Jan 22, 2013

Duration of Cardiopulmonary Resuscitation and Illness Category Impact Survival and Neurologic Outcomes for In-hospital Pediatric Cardiac Arrests

Renee I. Matos et al.
Background-Pediatric cardiopulmonary resuscitation (CPR) for >20 minutes has been considered futile after pediatric in-hospital cardiac arrests. This concept has recently been questioned.


Methods and Results - 3419 children from 328 US and Canadian sites (Get With The Guidelines-Resuscitation sites). In-hospital cardiac arrests between January 2000 and December 2009.

Patients were stratified into 5 patient illness categories: surgical cardiac, medical cardiac, general medical, general surgical, and trauma.

Survival to discharge was 27.9%, but only 19.0% of all cardiac arrest patients had favorable neurological outcomes.

Between 1 and 15 minutes of CPR, survival decreased linearly by 2.1% per minute, and rates of favorable neurological outcome decreased by 1.2% per minute.

Adjusted probability of survival was 41% for CPR duration of 1 to 15 minutes and 12% for >35 minutes.

Among survivors, favorable neurological outcome occurred in 70% undergoing <15 60="" and="" cpr="" minutes="" of="" undergoing="">35 minutes.

Compared with general medical patients, surgical cardiac patients had the highest adjusted odds ratios for survival and favorable neurological outcomes, 2.5 (95% confidence interval, 1.8-3.4) and 2.7 (95% confidence interval, 2.0-3.9), respectively.

Conclusions-CPR duration was independently associated with survival to hospital discharge and neurological outcome. Among survivors, neurological outcome was favorable for the majority of patients. Performing CPR for >20 minutes is not futile in some patient illness categories.