CardioPulmonary Resuscitation in Children: Outcome in a General Intensive Care Unit in Nigeria.

Background: Cardiopulmonary resuscitation (CPR) is the initiation of basic and advanced life support to restore spontaneous circulation after cardiac arrest. It is one of the most frequently performed procedures in the intensive care unit both in the adult and paediatric population. There are, however, significant differences in the aetiology of cardiac arrest and CPR in both age groups. The sequence and outcome of CPR for children, therefore, vary from that of the adult.

Methods: Records of all cardiac arrests and CPR performed for paediatric patients in a general ICU between 1st January 2012 and 30th June 2014 were retrieved and analysed. Cardiac arrests occurring outside the unit even though resuscitation was on-going on arrival at the ICU were excluded from the study. Socio-demographic characteristics of patients, diagnosis at admission, length of stay and outcome of resuscitative efforts were documented.

Results: A total of 44 cardiac arrests occurred in children during the study period. Successful outcome, defined as the return of spontaneous circulation to discharge from ICU was 15.5%. Trauma-related injuries (burns and head injury) and severe malaria accounted for the majority of cardiac arrests. Most (52.3%) cardiac arrests occurring in this group of patients took place outside working hours (4pm-8am). Successful outcome of CPR was dependent on age, length of ICU stay, duration of CPR and time of cardiac arrest.

Conclusion: The outcome of CPR in the paediatric population in our general ICU is poor. Perhaps, regular training of ICU staff in paediatric advanced life support and provision of an ICU dedicated to the care of paediatric patients may help improve outcome.