Kids can survive cardiac arrest with longer CPR

Children who experience in-hospital cardiac arrest may survive to discharge with fewer neurologic problems if they receive cardiopulmonary resuscitation (CPR) for a longer time, says new research that questioned the limitations of CPR lasting longer than 20 minutes.

Investigators analyzed data from the American Heart Association’s Get With the Guidelines-Resuscitation registry of in-hospital cardiac resuscitations for 3,149 children from 328 hospitals in the United States and Canada from January 2000 to December 2009.

Among the children who survived for 24 hours after the initial cardiac arrest, 28% survived to hospital discharge. Of these surviving patients, 16.6% had received CPR longer than 35 minutes. The highest rate of survival to discharge (44%) occurred among children given CPR between 1 and 15 minutes. It was thought previously that CPR given longer than 20 minutes was futile.

Although longer-duration CPR did benefit some children, survival rate declined rapidly. Between 1 and 15 minutes of CPR, the rate of survival decreased by 2.1% per minute of chest compression, and the rate of favorable neurologic outcome decreased by 1.2% per minute. However, 60% of surviving children who received more than 35 minutes of CPR had favorable neurologic outcomes compared with 70% of those who received less than 15 minutes of CPR.

The researchers concluded that the duration of CPR after in-hospital cardiac arrest was independently associated with survival to hospital discharge and that neurologic outcome was favorable for most of the survivors.