Abstract
A paucity of data is available on the cardiopulmonary resuscitation (CPR) of newborns. Since predictors of long term outcome following resuscitation would be extremely valuable we undertook a study to help define these variables. All admissions to the Neonatal ICU in a 30 month period (January 1981-June 1983) were reviewed to identify episodes of CPR. Of the 1341 charts reviewed, 83 patients met the criteria for a "code" consisting of CPR with or without medications or procedures. Sixty seven patients (81%) survived the initial arrest however 37 patients (44%) succumbed within 24 hrs. Eighteen patients (22%) died prior to discharge and twelve patients (14%) were eventually dismissed. Prior to arrest, significant predictors of poor outcome were a urine output of <1 cc/kg/hr, sepsis and postnatal age < 24 hours (p<0.04). A pH < 7.30 twenty four hours after CPR or the occurance of intraventricular hemorrhage subsequent to the code were significantly associated with ultimate demise. A Chi square analysis indicated that the requirements of intravenous lines or intubation during a code was advantageous (p<0.04). Survivors of CPR were more likely to have BPD, to be term gestation and not to have subsequent arrests (p<0.01). Six (55%) of the long term survivors (alive 6 months after discharge) were neurologically intact. Four (36%) were abnormal, but two of these infants had congenital anomalies associated with neurologic deficits. One patient was lost to follow-up. The clinical, socio-economic and ethical implications of this study warrant further analysis.
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Willett, L., Leuschen, M. & Nelson, R. OUTCOME OF CARDIOPULMONARY RESUSCITATION IN THE NEONATAL INTENSIVE CARE UNIT. Pediatr Res 18 (Suppl 4), 355 (1984). https://doi.org/10.1203/00006450-198404001-01575
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DOI: https://doi.org/10.1203/00006450-198404001-01575