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Pulseless electrical activity and asystolic cardiac arrest in infants: identifying factors that influence outcomes

Journal of Perinatology volume 42, pages 574–579 (2022)Cite this article

Subjects

Abstract

Background

There is limited information on pulseless electrical activity (PEA)/asystolic cardiac arrest (CA) in the infant population. The aim is to describe the incidence and factors associated with outcomes in infants with PEA/asystolic CA.

Methods

Single-center retrospective chart review study of infants less than one year of age who suffer in-hospital PEA/asystolic CA from January 1 2011 to June 30 2019. The primary outcome was the return of spontaneous circulation. The secondary outcome was survival to discharge.

Results

CA occurred in 148 infants and PEA/asystolic was found in 38 (26%). Of those 29 (76%) achieved ROSC, and 12 (32%) survived to discharge. Infants on inotrope support or receiving longer duration of chest compressions and epinephrine had increase mortality. All infants with respiratory etiology of arrest survived to hospital discharge.

Conclusion

PEA/asystolic CAs are uncommon. Poor prognostic indicators include the need for pre-arrest inotrope support and increased duration of chest compressions.

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Fig. 1: Flow diagram of the CPR events included in the analysis.
Fig. 2: PEA/asystolic outcomes based on the location of the arrest.

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Authors contributors

KB and NA conceptualized and designed the study, drafted the initial manuscript and reviewed the manuscript. MHW helped with the study design and critically reviewed the manuscript. RH and ES analyzed the data and critically reviewed the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Authors and Affiliations

  1. UT Southwestern Medical Center Department of Pediatrics Division of Critical Care Medicine, Dallas, TX, USA

    Kathryn Best & Ethan Sandford

  2. UT Southwestern Medical Center Department of Pediatrics Division of Neonatal-Perinatal Medicine, Dallas, TX, USA

    Myra H. Wyckoff & Noorjahan Ali

  3. Children’s Medical Center Dallas Department of Biostatistics, Dallas, TX, USA

    Rong Huang

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  1. Kathryn Best
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Correspondence to Noorjahan Ali.

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Best, K., Wyckoff, M.H., Huang, R. et al. Pulseless electrical activity and asystolic cardiac arrest in infants: identifying factors that influence outcomes. J Perinatol 42, 574–579 (2022). https://doi.org/10.1038/s41372-022-01349-x

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