Paediatric traumatic cardiac arrest: survival is possible from resuscitation

  • Vassallo J & al.
  • Arch Dis Child
  • 27 Sep 2018

  • curated by Antara Ghosh
  • UK Clinical Digest
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Takeaway

  • Survival is possible from resuscitation of paediatric traumatic cardiac arrest (TCA), with overall survival comparable to that reported in adults.
  • Highest survival was observed in children with a pre-hospital only TCA, and in children transported to major trauma centre.

Why this matters

  • Findings advocate early identification and aggressive management of paediatric TCA.
  • Development of a standardised, best practice approach guideline is recommended.

Study design

  • Retrospective study evaluated 129 paediatric/adolescent patients (ages,
  • Funding: None disclosed.

Key results

  • 35.7% of patients had a pre-hospital only TCA, 44.2% had both pre-hospital and in-hospital TCA, and 20.2% had in-hospital only TCA.
  • Overall 30-day survival was 5.4% (95% CI, 2.7%-10.8%).
  • Patients with pre-hospital only TCA were more likely to survive vs those with in-hospital TCA (13.0% vs 1.8%; P=.04).
  • Survival in those transported to a paediatric major trauma centre was 10.3% (95% CI, 4.8%-20.8%).
  • Most prevalent mechanism of injury was road traffic collisions (56.6%) followed by stabbing and shootings (14.0%) and falls above 2 meters (12.4%).
  • TCA was associated with haemorrhage, traumatic brain injury and both traumatic brain injury and haemorrhage in 24.8%, 15.5% and 55.0% of patients, respectively.

Limitations

  • Unadjusted analysis.

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