EFFICACY OF CARDIOPULMONARY-RESUSCITATION IN PULSELESS PEDIATRIC TRAUMA PATIENTS

Background: A study was designed to determine which paediatric trauma patients with no detectable vital signs are likely to benefit from car diopulmonary resuscitation (CPR). Methods: A 10-year retrospective stu dy of all pulseless patients under 16 years of age with trauma in whom CPR was initiated in a prehospital or in-hospital setting in Southern Finland. Results: Forty-one patients. 25 male and 16 female, were inc luded in this study. The mean age was 7.8 years (range 0.1-15.9 years) . Twenty three patients had blunt injuries and three patients had pene trating injuries. The mean Injury Severity Score was 51 (range 25-75). In 15 patients, the arrest was secondary to smoke inhalation, strangu lation or electric shock. Resuscitation was initiated at the scene or en route in 28 patients and in 13 patients at the hospital. Five patie nts received open-chest CPR and 36 patients closed-chest CPR. Spontane ous circulation was restored in four patients with open-chest CPR and in six patients with closed-chest CPR. Two patients had intact surviva l and one patient survived with moderate disability, The mechanism of traumatic cardiac arrest, initial cardiac rhythm or location of arrest did not seem to affect outcome of CPR, Conclusions: The overall survi val rate of paediatric patients with cardiac arrest secondary to traum a is poor. Trauma patients in whom cardiac arrest is caused by respira tory arrest or by thoracoabdominal trauma in the hospital setting may have a chance of survival if a spontaneous circulation is rapidly rest ored with effective resuscitative measures. (C) 1998 Elsevier Science Ireland Ltd.