OBJECTIVES The objective of this study is to determine outcomes of recurrent cardiac arrest events in the general pediatric inpatient population. DESIGN Retrospective cohort study of inpatients in a single institution. SETTING A tertiary care free-standing children's hospital. PATIENTS All patients less than 18 years old at Seattle Children's Hospital with recurrent cardiac arrest events occurring from January 1, 2010, to March 1, 2018, were included. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Overall survival to hospital discharge was 50% and all survivors had a good neurologic outcome, defined as Pediatric Cerebral Performance Category of 3 or less, or unchanged from baseline. Survival among patients who received extracorporeal life support was 43% and among those who received extracorporeal cardiopulmonary resuscitation, 33%. Initial arrest factors associated with survival included initial rhythm of ventricular tachycardia or ventricular fibrillation, shorter duration of cardiopulmonary resuscitation, and absence of multiple organ dysfunction. Additionally, nonsurvivors had more severe metabolic acidosis in the prearrest and postarrest period. CONCLUSIONS Survival after pediatric in-hospital recurrent cardiac arrest is higher than previously reported. There is also evidence that initial rhythm other than ventricular tachycardia/ventricular fibrillation and longer duration of cardiopulmonary resuscitation as well as multiple organ dysfunction and more severe lactic acidosis in the peri-arrest period are associated with poor outcomes.

中文翻译：

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住院小儿复发性心脏骤停后的结果。

目的本研究的目的是确定普通儿科住院患者中反复出现的心脏骤停事件的结果。设计对单个机构中的住院患者进行回顾性队列研究。设置一家三级护理独立儿童医院。患者包括2010年1月1日至2018年3月1日发生在西雅图儿童医院的所有未满18岁的复发性心脏骤停事件的患者。干预措施无。测量和主要结果出院的总生存率为50％，所有幸存者均具有良好的神经系统预后，定义为小儿脑功能分类为3或以下，或与基线水平持平。接受体外生命支持的患者的生存率为43％，接受体外心肺复苏的患者为33％。与生存相关的初始逮捕因素包括室性心动过速或室颤的初始节律，心肺复苏的持续时间较短以及没有多器官功能障碍。另外，非幸存者在逮捕前和逮捕后期间有更严重的代谢性酸中毒。结论小儿院内复发性心脏骤停后的存活率高于先前报道。也有证据表明，除了室速/心室颤动以外的初始节律，心肺复苏的持续时间更长，围捕期多器官功能障碍和更严重的乳酸性酸中毒均与不良预后相关。心肺复苏的持续时间较短，并且没有多器官功能障碍。此外，非幸存者在逮捕前和逮捕后期间有更严重的代谢性酸中毒。结论小儿院内复发性心脏骤停后的存活率高于先前报道。也有证据表明，除了室速/心室颤动以外的初始节律，心肺复苏的持续时间更长，围捕期多器官功能障碍和更严重的乳酸性酸中毒均与不良预后相关。心肺复苏的持续时间较短，并且没有多器官功能障碍。此外，非幸存者在逮捕前和逮捕后期间有更严重的代谢性酸中毒。结论小儿院内复发性心脏骤停后的存活率高于先前报道。也有证据表明，除了室速/心室颤动以外的初始节律，心肺复苏的持续时间更长，围捕期多器官功能障碍和更严重的乳酸性酸中毒均与不良预后相关。结论小儿院内复发性心脏骤停后的存活率高于先前报道。也有证据表明，除了室速/心室颤动以外的初始节律，心肺复苏的持续时间更长，围捕期多器官功能障碍和更严重的乳酸性酸中毒均与不良预后相关。结论小儿院内复发性心脏骤停后的存活率高于先前报道。也有证据表明，除了室速/心室颤动以外的初始节律，心肺复苏的持续时间更长，围捕期多器官功能障碍和更严重的乳酸性酸中毒均与不良预后相关。