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Calcium use during paediatric in-hospital cardiac arrest is associated with worse outcomes.

Publication ,  Journal Article
Cashen, K; Sutton, RM; Reeder, RW; Ahmed, T; Bell, MJ; Berg, RA; Burns, C; Carcillo, JA; Carpenter, TC; Michael Dean, J; Wesley Diddle, J ...
Published in: Resuscitation
April 2023

AIM: To evaluate associations between calcium administration and outcomes among children with in-hospital cardiac arrest and among specific subgroups in which calcium use is hypothesized to provide clinical benefit. METHODS: This is a secondary analysis of observational data collected prospectively as part of the ICU-RESUScitation project. Children 37 weeks post-conceptual age to 18 years who received chest compressions in one of 18 intensive care units from October 2016-March 2021 were eligible. Data included child and event characteristics, pre-arrest laboratory values, pre- and intra-arrest haemodynamics, and outcomes. Outcomes included sustained return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with favourable neurologic outcome. A propensity score weighted cohort was used to evaluate associations between calcium use and outcomes. Subgroups included neonates, and children with hyperkalaemia, sepsis, renal insufficiency, cardiac surgery with cardiopulmonary bypass, and calcium-avid cardiac diagnoses. RESULTS: Of 1,100 in-hospital cardiac arrests, median age was 0.63 years (IQR 0.19, 3.81); 450 (41%) received calcium. Among the weighted cohort, calcium use was not associated with sustained ROSC (aOR, 0.87; CI95 0.61-1.24; p = 0.445), but was associated with lower rates of both survival to hospital discharge (aOR, 0.68; CI95 0.52-0.89; p = 0.005) and survival with favourable neurologic outcome at hospital discharge (aOR, 0.75; CI95 0.57-0.98; p = 0.038). Among subgroups, calcium use was associated with lower rates of survival to hospital discharge in children with sepsis and renal insufficiency. CONCLUSIONS: Calcium use was common during paediatric in-hospital cardiac arrest and associated with worse outcomes at hospital discharge.

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Published In

Resuscitation

DOI

EISSN

1873-1570

Publication Date

April 2023

Volume

185

Start / End Page

109673

Location

Ireland

Related Subject Headings

  • Retrospective Studies
  • Patient Discharge
  • Infant, Newborn
  • Infant
  • Humans
  • Hospitals, Pediatric
  • Heart Arrest
  • Emergency & Critical Care Medicine
  • Child
  • Cardiopulmonary Resuscitation
 

Citation

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Chicago
ICMJE
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Cashen, K., Sutton, R. M., Reeder, R. W., Ahmed, T., Bell, M. J., Berg, R. A., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) and National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators, . (2023). Calcium use during paediatric in-hospital cardiac arrest is associated with worse outcomes. Resuscitation, 185, 109673. https://doi.org/10.1016/j.resuscitation.2022.109673
Cashen, Katherine, Robert M. Sutton, Ron W. Reeder, Tageldin Ahmed, Michael J. Bell, Robert A. Berg, Candice Burns, et al. “Calcium use during paediatric in-hospital cardiac arrest is associated with worse outcomes.Resuscitation 185 (April 2023): 109673. https://doi.org/10.1016/j.resuscitation.2022.109673.
Cashen K, Sutton RM, Reeder RW, Ahmed T, Bell MJ, Berg RA, et al. Calcium use during paediatric in-hospital cardiac arrest is associated with worse outcomes. Resuscitation. 2023 Apr;185:109673.
Cashen, Katherine, et al. “Calcium use during paediatric in-hospital cardiac arrest is associated with worse outcomes.Resuscitation, vol. 185, Apr. 2023, p. 109673. Pubmed, doi:10.1016/j.resuscitation.2022.109673.
Cashen K, Sutton RM, Reeder RW, Ahmed T, Bell MJ, Berg RA, Burns C, Carcillo JA, Carpenter TC, Michael Dean J, Wesley Diddle J, Federman M, Fink EL, Franzon D, Frazier AH, Friess SH, Graham K, Hall M, Hehir DA, Horvat CM, Huard LL, KirkpatrickN T, Maa T, Manga A, McQuillen PS, Morgan RW, Mourani PM, Nadkarni VM, Naim MY, Notterman D, Page K, Pollack MM, Qunibi D, Sapru A, Schneiter C, Sharron MP, Srivastava N, Viteri S, Wessel D, Wolfe HA, Yates AR, Zuppa AF, Meert KL, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) and National Heart Lung and Blood Institute ICU-RESUScitation Project Investigators. Calcium use during paediatric in-hospital cardiac arrest is associated with worse outcomes. Resuscitation. 2023 Apr;185:109673.
Journal cover image

Published In

Resuscitation

DOI

EISSN

1873-1570

Publication Date

April 2023

Volume

185

Start / End Page

109673

Location

Ireland

Related Subject Headings

  • Retrospective Studies
  • Patient Discharge
  • Infant, Newborn
  • Infant
  • Humans
  • Hospitals, Pediatric
  • Heart Arrest
  • Emergency & Critical Care Medicine
  • Child
  • Cardiopulmonary Resuscitation