Table 2.
Event Characteristics by Calcium Use
| Calcium use | |||
|---|---|---|---|
| No (N = 650) | Yes (N = 450) | P-value | |
| Pre-event characteristics | |||
| Illness category | 0.0022 | ||
| Medical cardiac | 161 (24.8%) | 106 (23.6%) | |
| Surgical cardiac | 193 (29.7%) | 178 (39.6%) | |
| Non-cardiac | 296 (45.5%) | 166 (36.9%) | |
| Baseline PCPC score1 | 0.0674 | ||
| 1 - Normal | 375 (57.7%) | 294 (65.3%) | |
| 2 - Mild disability | 127 (19.5%) | 70 (15.6%) | |
| 3 - Moderate disability | 77 (11.8%) | 38 (8.4%) | |
| 4 - Severe disability | 63 (9.7%) | 44 (9.8%) | |
| 5 - Coma/vegetative state | 8 (1.2%) | 4 (0.9%) | |
| Baseline FSS1 | 7.0 [6.0, 11.0] | 6.0 [6.0, 9.0] | 0.0053 |
| Vasoactive inotropic score 2 hours prior to the event | <.0013 | ||
| None | 425 (65.4%) | 214 (47.6%) | |
| 0 – 20 | 188 (28.9%) | 184 (40.9%) | |
| > 20 | 37 (5.7%) | 52 (11.6%) | |
| PRISM 2 – 6 hours prior to the event | 3.0 [0.0, 8.0] | 6.0 [1.0, 12.0] | <.0013 |
| Glasgow Coma Scale | 11.0 [5.0, 14.0] | 11.0 [3.0, 14.0] | 0.4633 |
| Highest serum potassium (mmol/L) | 3.9 [3.4, 4.5] | 3.9 [3.3, 4.7] | 0.8703 |
| Hyperkalaemia (potassium ≥6 mmol/L prior to the CPR event) | 10 (1.5%) | 20 (4.4%) | 0.0572 |
| Event characteristics | |||
| Location of CPR Event | 0.0052 | ||
| PICU | 339 (52.2%) | 195 (43.3%) | |
| CICU | 311 (47.8%) | 255 (56.7%) | |
| Duration of CPR (minutes) | 3.0 [1.0, 7.0] | 21.0 [9.0, 45.0] | <.0013 |
| Duration of CPR (minutes) | <.0012 | ||
| <6 | 439 (67.5%) | 67 (14.9%) | |
| 6–15 | 116 (17.8%) | 107 (23.8%) | |
| 16–35 | 58 (8.9%) | 126 (28.0%) | |
| >35 | 37 (5.7%) | 150 (33.3%) | |
| CPR time5 | 0.3952 | ||
| Weekday | 337 (51.8%) | 246 (54.7%) | |
| Weeknight | 124 (19.1%) | 90 (20.0%) | |
| Weekend | 189 (29.1%) | 114 (25.3%) | |
| First documented rhythm | 0.0022 | ||
| Asystole | 73 (11.2%) | 48 (10.7%) | |
| Bradycardia with pulses | 365 (56.2%) | 203 (45.1%) | |
| Pulseless electrical activity | 162 (24.9%) | 157 (34.9%) | |
| Ventricular fibrillation | 15 (2.3%) | 17 (3.8%) | |
| Ventricular tachycardia | 35 (5.4%) | 25 (5.6%) | |
| Immediate cause | |||
| Hypotension | 278 (42.8%) | 311 (69.1%) | <.0012 |
| Respiratory decompensation | 393 (60.5%) | 204 (45.3%) | <.0012 |
| Cyanosis without respiratory decompensation | 29 (4.5%) | 20 (4.4%) | 1.0002 |
| Arrhythmia | 102 (15.7%) | 91 (20.2%) | 0.0532 |
| Interventions in place | |||
| Central venous catheter | 419 (64.5%) | 331 (73.6%) | 0.0022 |
| Vasoactive infusion | 275 (42.3%) | 292 (64.9%) | <.0012 |
| Invasive mechanical ventilation | 429 (66.0%) | 347 (77.1%) | <.0012 |
| Non-invasive ventilation | 131 (20.2%) | 70 (15.6%) | 0.0572 |
| Sternum open at start of CPR event | 46 (7.1%) | 60 (13.3%) | <.0012 |
| Sternum opened during CPR event | 12 (1.8%) | 39 (8.7%) | <.0012 |
| Pharmacologic interventions during CPR | |||
| Adrenaline (Epinephrine) | 425 (65.4%) | 447 (99.3%) | <.0012 |
| Adrenaline bolus administered in ≤ 5 minutes | 405/425 (95.3%) | 414/447 (92.6%) | 0.1192 |
| Atropine | 62 (9.5%) | 61 (13.6%) | 0.0412 |
| Sodium bicarbonate | 148 (22.8%) | 380 (84.4%) | <.0012 |
| Vasopressin | 6 (0.9%) | 35 (7.8%) | <.0012 |
| Amiodarone | 11 (1.7%) | 29 (6.4%) | <.0012 |
| Lidocaine | 16 (2.5%) | 29 (6.4%) | 0.0022 |
| Fluid bolus | 91 (14.0%) | 192 (42.7%) | <.0012 |
| Post-CPR characteristics | |||
| ECMO within 6-hours6 | 37/592 (6.3%) | 34/305 (11.1%) | 0.0132 |
| ECMO within 24-hours6 | 47/592 (7.9%) | 45/305 (14.8%) | <.0012 |
| Highest arterial lactate (mmol/L) (0 – 6 hours) | 5.4 [2.2, 10.2] | 10.3 [5.7, 16.1] | <.0013 |
| Highest arterial lactate (mmol/L) (6 – 24 hours) | 2.3 [1.3, 5.1] | 4.1 [2.2, 8.5] | <.0013 |
PCPC = Pediatric Cerebral Performance Category; FSS = functional status scale; PRISM = Pediatric Risk of Mortality; CPR = cardiopulmonary resuscitation; PICU = pediatric intensive care unit; CICU = cardiac intensive care unit; ECMO = extracorporeal membrane oxygenation.
Baseline PCPC and FSS represent the child’s status prior to the event leading to hospitalization.
Fisher’s exact test.
Wilcoxon rank-sum test.
Cochran-Armitage test for trend.
Weekday is between 7 AM and 11 PM Monday - Friday; weeknight is between 11 PM and 7 AM Monday - Thursday; Weekend is from 11 PM on Friday through 7 AM on the following Monday.
Denominator does not include those who transitioned to ECMO as their immediate outcome of CPR event.