Background: The outcome of pediatric cardiac arrest is poor, and attem
pts to improve it have not been very successful. The aim of this study
was to analyze the outcome of a large number of in-hospital pediatric
cardiac arrest patients, and to determine the factors that influence
this outcome. Patients and Methods: The records of hospital inpatients
at King Faisal Specialist Hospital and Research Centre who received e
xternal cardiac massage as part of their cardiopulmonary resuscitation
were reviewed. Success of resuscitation was analyzed as: 1) short-ter
m (restoration of spontaneous circulation); and 2) long-term (discharg
e from hospital). Results: Of 234 such patients, 171 (73.1%) survived
the initial resuscitation, and 66 (28.2%) were discharged from hospita
l. Success of outcome was not related to age, time of day, or location
of arrest. Longer resuscitation time was associated with less chance
of restoration of spontaneous circulation (P < 0.001), and lower hospi
tal discharge rate. Results for patients with congenital heart disease
were similar to those with other medical or surgical conditions. Rest
oration of spontaneous circulation from asystole was more difficult wh
en compared to other arrest rhythm, but once circulation was restored,
long-term outcome was not influenced by rhythm. Conclusion: Asystole
and longer resuscitation time are associated with poorer outcome, howe
ver, successful restoration of spontaneous circulation with long-term
survival can be achieved after prolonged resuscitation.