Abstract
Introduction: Survival in pediatric ICU pts with CA has been reported primarily in small series of patients from single-center sites. While survival has been reported as 50-65%, pts who need mechanical ventilation (MV) or vasoactive infusions (VI) have poor survival to <30%. This analysis was undertaken to assess the outcome of CA pts who require ICU admission in the current era utilizing a large, multi-center population. Methods:Data was obtained from the Pediatric Intensive Care Unit Evaluations (PICUEs) database, which maintains data on PICU pts from the USA (n=20 sites for this report, 1996-1998 data). Results:CA pts formed 6% (1120) of total PICU admissions (19,553). Survival in CA pts was 94% vs 97% in non-CA pts. Outcome of pts varied by diagnosis, need for VI or MV and outcome (see Table). MV was associated with decreased survival in all subgroups (p<.005). Of MV pts, those with shock had poorest survival (25%);postoperative pts had best survival (94%).PRISM III was greater in deaths than survivors (15.9 ± 9.6 vs 3.7 ± 5.3, p<.05). Conclusions: In this evaluation of over 1000 CA pts admitted to 20 PICU's, survival is 94%. Even in pts who need VI or MV, survival is >50%. Previous reports from small series or single sites may overestimate risk of mortality in the current era. Surv Surv + MV Died Died + MV Total CA pts 1047(94%) 224(80%) 73(6%) 57(20%) Meningitis 2 (67%) 1 (50%) 1 (33%) 1 (50%) Pneumonia 18(69%) 8(67%) 8(31%) 4(33%) Sepsis 47(72%) 13(46%) 18(28%) 15(54%) Shock 16(64%) 3(25%) 9(36%) 9(75%) VI 111(68%) 57(53%) 52(32%) 50(47%).