Long-term outcomes of burned children after in-hospital cardiac arrest

Marc G. Jeschke, David Herndon, Robert E. Barrow

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: Cardiopulmonary resuscitation (CPR) in severely burned patients experiencing cardiac arrest (CA) has been considered by some as futile. The objective of this article is to report predisposing factors and the outcomes of burned children experiencing in-hospital CA at our institution. Design: The records of 595 children admitted from 1985 to 1998 with burns covering >35% of their total body surface area were reviewed. Thirty-four children receiving CPR after in-hospital CA were studied for predisposing factors and long-term outcomes. Setting and Patients: Shriners Burns Hospital. Burned children of both genders, 0.5-19 yrs of age, who experienced in-hospital CA and received CPR. Intervention: Standard burn care and CPR. Measurements and Main Results: Predisposing factors of CA, mortality, and long-term outcomes were measured. The incidence of CA in burned children with burns on >35% total body surface area was 5.7%. No significant difference in age or burn size could be shown between long-term CA survivors (n = 17) and nonsurvivors (n = 17). CPR was successful (defined as survival for at least 1 day after CA) in 22 of 34 children (65%), with 17 of the 22 survivors (77%) experiencing long-term survival, currently from 2- 14 yrs. Significant predisposing factors of CA were sepsis, identified in 53% of the nonsurvivors vs. 12% of the survivors (p < .05), and delayed fluid resuscitation (>2 hrs after burn injury), identified in 82% of the nonsurvivors vs. 6% of the survivors (p < .001). There was only one morbid long-term survivor. This survivor was diagnosed as having anoxic brain injury with persistent neurologic deficiencies. Conclusion: In this study, 50% of the burned children experiencing CA are long-term survivors. We suggest that all burned children with CA should be afforded cardiopulmonary resuscitation.

Original languageEnglish (US)
Pages (from-to)517-520
Number of pages4
JournalCritical Care Medicine
Volume28
Issue number2
StatePublished - 2000

Fingerprint

Heart Arrest
Cardiopulmonary Resuscitation
Survivors
Causality
Burns
Body Surface Area
Survival
Brain Injuries
Nervous System
Sepsis
Mortality

Keywords

  • Burns
  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Children
  • Fluid resuscitation
  • Long-term outcomes
  • Mortality
  • Multiple organ failure
  • Renal failure
  • Sepsis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Jeschke, M. G., Herndon, D., & Barrow, R. E. (2000). Long-term outcomes of burned children after in-hospital cardiac arrest. Critical Care Medicine, 28(2), 517-520.

Long-term outcomes of burned children after in-hospital cardiac arrest. / Jeschke, Marc G.; Herndon, David; Barrow, Robert E.

In: Critical Care Medicine, Vol. 28, No. 2, 2000, p. 517-520.

Research output: Contribution to journalArticle

Jeschke, MG, Herndon, D & Barrow, RE 2000, 'Long-term outcomes of burned children after in-hospital cardiac arrest', Critical Care Medicine, vol. 28, no. 2, pp. 517-520.
Jeschke, Marc G. ; Herndon, David ; Barrow, Robert E. / Long-term outcomes of burned children after in-hospital cardiac arrest. In: Critical Care Medicine. 2000 ; Vol. 28, No. 2. pp. 517-520.
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abstract = "Objective: Cardiopulmonary resuscitation (CPR) in severely burned patients experiencing cardiac arrest (CA) has been considered by some as futile. The objective of this article is to report predisposing factors and the outcomes of burned children experiencing in-hospital CA at our institution. Design: The records of 595 children admitted from 1985 to 1998 with burns covering >35{\%} of their total body surface area were reviewed. Thirty-four children receiving CPR after in-hospital CA were studied for predisposing factors and long-term outcomes. Setting and Patients: Shriners Burns Hospital. Burned children of both genders, 0.5-19 yrs of age, who experienced in-hospital CA and received CPR. Intervention: Standard burn care and CPR. Measurements and Main Results: Predisposing factors of CA, mortality, and long-term outcomes were measured. The incidence of CA in burned children with burns on >35{\%} total body surface area was 5.7{\%}. No significant difference in age or burn size could be shown between long-term CA survivors (n = 17) and nonsurvivors (n = 17). CPR was successful (defined as survival for at least 1 day after CA) in 22 of 34 children (65{\%}), with 17 of the 22 survivors (77{\%}) experiencing long-term survival, currently from 2- 14 yrs. Significant predisposing factors of CA were sepsis, identified in 53{\%} of the nonsurvivors vs. 12{\%} of the survivors (p < .05), and delayed fluid resuscitation (>2 hrs after burn injury), identified in 82{\%} of the nonsurvivors vs. 6{\%} of the survivors (p < .001). There was only one morbid long-term survivor. This survivor was diagnosed as having anoxic brain injury with persistent neurologic deficiencies. Conclusion: In this study, 50{\%} of the burned children experiencing CA are long-term survivors. We suggest that all burned children with CA should be afforded cardiopulmonary resuscitation.",
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AU - Jeschke, Marc G.

AU - Herndon, David

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N2 - Objective: Cardiopulmonary resuscitation (CPR) in severely burned patients experiencing cardiac arrest (CA) has been considered by some as futile. The objective of this article is to report predisposing factors and the outcomes of burned children experiencing in-hospital CA at our institution. Design: The records of 595 children admitted from 1985 to 1998 with burns covering >35% of their total body surface area were reviewed. Thirty-four children receiving CPR after in-hospital CA were studied for predisposing factors and long-term outcomes. Setting and Patients: Shriners Burns Hospital. Burned children of both genders, 0.5-19 yrs of age, who experienced in-hospital CA and received CPR. Intervention: Standard burn care and CPR. Measurements and Main Results: Predisposing factors of CA, mortality, and long-term outcomes were measured. The incidence of CA in burned children with burns on >35% total body surface area was 5.7%. No significant difference in age or burn size could be shown between long-term CA survivors (n = 17) and nonsurvivors (n = 17). CPR was successful (defined as survival for at least 1 day after CA) in 22 of 34 children (65%), with 17 of the 22 survivors (77%) experiencing long-term survival, currently from 2- 14 yrs. Significant predisposing factors of CA were sepsis, identified in 53% of the nonsurvivors vs. 12% of the survivors (p < .05), and delayed fluid resuscitation (>2 hrs after burn injury), identified in 82% of the nonsurvivors vs. 6% of the survivors (p < .001). There was only one morbid long-term survivor. This survivor was diagnosed as having anoxic brain injury with persistent neurologic deficiencies. Conclusion: In this study, 50% of the burned children experiencing CA are long-term survivors. We suggest that all burned children with CA should be afforded cardiopulmonary resuscitation.

AB - Objective: Cardiopulmonary resuscitation (CPR) in severely burned patients experiencing cardiac arrest (CA) has been considered by some as futile. The objective of this article is to report predisposing factors and the outcomes of burned children experiencing in-hospital CA at our institution. Design: The records of 595 children admitted from 1985 to 1998 with burns covering >35% of their total body surface area were reviewed. Thirty-four children receiving CPR after in-hospital CA were studied for predisposing factors and long-term outcomes. Setting and Patients: Shriners Burns Hospital. Burned children of both genders, 0.5-19 yrs of age, who experienced in-hospital CA and received CPR. Intervention: Standard burn care and CPR. Measurements and Main Results: Predisposing factors of CA, mortality, and long-term outcomes were measured. The incidence of CA in burned children with burns on >35% total body surface area was 5.7%. No significant difference in age or burn size could be shown between long-term CA survivors (n = 17) and nonsurvivors (n = 17). CPR was successful (defined as survival for at least 1 day after CA) in 22 of 34 children (65%), with 17 of the 22 survivors (77%) experiencing long-term survival, currently from 2- 14 yrs. Significant predisposing factors of CA were sepsis, identified in 53% of the nonsurvivors vs. 12% of the survivors (p < .05), and delayed fluid resuscitation (>2 hrs after burn injury), identified in 82% of the nonsurvivors vs. 6% of the survivors (p < .001). There was only one morbid long-term survivor. This survivor was diagnosed as having anoxic brain injury with persistent neurologic deficiencies. Conclusion: In this study, 50% of the burned children experiencing CA are long-term survivors. We suggest that all burned children with CA should be afforded cardiopulmonary resuscitation.

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KW - Children

KW - Fluid resuscitation

KW - Long-term outcomes

KW - Mortality

KW - Multiple organ failure

KW - Renal failure

KW - Sepsis

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