Outcome of Out-of-hospital Cardiac Arrest in Preschool Children

Background: Determine the survival rate among children after out-of-hospital cardiac arrest (OHCA) and identify predictors of survival. Methods: This is a retrospective study over a 6.1-year period at a medical center in central Taiwan. Children younger than 6 years old with apnea and no palpable pulse who presented to the emergency department (ED) were enrolled in a chart review. The characteristics of the patients and the outcomes of illness were analyzed. Results: From January 1999 to February 2005, 58 young children who came to the ED without a palpable pulse were enrolled in our study. Thirty-nine patients (68%) had no return of spontaneous circulation (ROSC) in the ED and 19 patients (32%) had a ROSC and were admitted to the ICU. Factors that predicted ROSC included a short interval from starting cardiopulmonary resuscitation (CPR) to ROSC in the ED and the administration of fewer doses of epinephrine in the ED. Only 2 patients (3%) survived to hospital discharge, and both had neurologic sequelae. Conclusions: These results suggest that OHCA among young children has a very poor prognosis. A shorter interval from starting CPR to ROSC and administration of fewer doses of epinephrine in the ED were the main factors predicting survival to hospital admission. Prolonged CPR can not increase the survival rate in preschool OHCA children.