Long-term outcomes of burned children after in-hospital cardiac arrest

Objective: Cardiopulmonary resuscitation (CPR) in severely burned patients experiencing cardiac arrest (GA) has been considered by some as futile, The objective of this article is to report predisposing factors and the outcom es of burned children experiencing in-hospital CA at our institution. Design: The records of 595 children admitted from 1985 to 1998 with burns c overing >35% of their total body surface area were reviewed. Thirty-four ch ildren receiving CPR after in-hospital CA were studied for predisposing fac tors and long-term outcomes, Setting and Patients: Shriners Burns Hospital. Burned children of both gend ers, 0.5-19 yrs of age, who experienced in-hospital CA and received CPR, Intervention: Standard burn care and CPR. Measurements and Main Results: Predisposing factors of CA, mortality, and l ong-term outcomes were measured, The incidence of GA in burned children wit h burns on >35% total body surface area was 5.7%, No significant difference in age or burn size could be shown between long-term CA survivors (n = 17) and nonsurvivors (n = 17), CPR was successful (defined as survival for at least 1 day after GA) in 22 of 34 children (65%), with 17 of the 22 survivo rs (77%) experiencing long-term survival, currently from 2-14 yrs, Signific ant predisposing factors of GA were sepsis, identified in 53% of the nonsur vivors vs, 12% of the survivors (p < .05), and delayed fluid resuscitation (>2 hrs after burn injury), identified in 82% of the nonsurvivors vs, 6% of the survivors (p < .001), There was only one morbid long-term survivor, Th is survivor was diagnosed as having anoxic brain injury with persistent neu rologic deficiencies. Conclusion: In this study, 50% of the burned children experiencing GA are l ong-term survivors. We suggest that all burned children with CA should be a fforded cardiopulmonary resuscitation.