@article{3609,
  keywords = {Humans, Time Factors, Female, Male, Prospective Studies, Infant, Diastole, Heart Arrest, Survival Rate, Hypertension},
  author = {Alexis Topjian and Robert Sutton and Ron Reeder and Russell Telford and Kathleen Meert and Andrew Yates and Ryan Morgan and John Berger and Christopher Newth and Joseph Carcillo and Patrick McQuillen and Rick Harrison and Frank Moler and Murray Pollack and Todd Carpenter and Daniel Notterman and Richard Holubkov and J Michael Dean and Vinay Nadkarni and Robert Berg and Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators and Athena Zuppa and Katherine Graham and Carolann Twelves and Mary Diliberto and William Landis and Elyse Tomanio and Jeni Kwok and Michael Bell and Alan Abraham and Anil Sapru and Mustafa Alkhouli and Sabrina Heidemann and Ann Pawluszka and Mark Hall and Lisa Steele and Thomas Shanley and Monica Weber and Heidi Dalton and Aimee La Bell and Peter Mourani and Kathryn Malone and Christopher Locandro and Whitney Coleman and Alecia Peterson and Julie Thelen and Allan Doctor},
  title = {The association of immediate post cardiac arrest diastolic hypertension and survival following pediatric cardiac arrest.},
  abstract = { <p><b>AIM: </b>In-hospital cardiac arrest occurs in >5000 children each year in the US and almost half will not survive to discharge. Animal data demonstrate that an immediate post-resuscitation burst of hypertension is associated with improved survival. We aimed to determine if systolic and diastolic invasive arterial blood pressures immediately (0-20 min) after return of spontaneous circulation (ROSC) are associated with survival and neurologic outcomes at hospital discharge.</p><p><b>METHODS: </b>This is a secondary analysis of the Pediatric Intensive Care Quality of CPR (PICqCPR) study of invasively measured blood pressures during intensive care unit CPR. Patients were eligible if they achieved ROSC and had at least one invasively measured blood pressure within the first 20 min following ROSC. Post-ROSC blood pressures were normalized for age, sex and height. "Immediate hypertension" was defined as at least one systolic or diastolic blood pressure >90th percentile. The primary outcome was survival to hospital discharge.</p><p><b>RESULTS: </b>Of 102 children, 70 (68.6\%) had at least one episode of immediate post-CPR diastolic hypertension. After controlling for pre-existing hypotension, duration of CPR, calcium administration, and first documented rhythm, patients with immediate post-CPR diastolic hypertension were more likely to survive to hospital discharge (79.3\% vs. 54.5\%; adjusted OR = 2.93; 95\%CI, 1.16-7.69).</p><p><b>CONCLUSIONS: </b>In this post hoc secondary analysis of the PICqCPR study, 68.6\% of subjects had diastolic hypertension within 20 min of ROSC. Immediate post-ROSC hypertension was associated with increased odds of survival to discharge, even after adjusting for covariates of interest.</p> },
  year = {2019},
  journal = {Resuscitation},
  volume = {141},
  pages = {88-95},
  month = {2019 Aug},
  issn = {1873-1570},
  doi = {10.1016/j.resuscitation.2019.05.033},
  language = {eng},
}