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• W4313222433 abstract "Introduction: Post cardiac arrest blood pressure < 5th percentile for age is associated with worse survival to discharge. There are limited data on the impact of mean arterial pressure (MAP) on favorable neurologic outcome. We hypothesized, in the first 6-hours post-return of spontaneous circulation (ROSC), that a minimum documented MAP >5th percentile is associated with better neurologic outcomes. Methods: Prospective, multi-center, observational study using data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q). Children (< 18 years) who achieved ROSC (without ECMO) following index in-hospital or out-of-hospital cardiac arrest and survived ≥6 hours were included. Minimum documented MAP within the first 6 hours of ROSC was percentile adjusted for age based on normative data and categorized into 6 groups: Group I= < 5th percentile; II= 5–24th; III= 25–49th; IV= 50–74th; V= 75–94th; and VI= ≥95th. Primary outcome was favorable neurologic status at hospital discharge, defined as PCPC score ≤2 or no change from pre-arrest baseline. Multivariable logistic regression was performed to estimate the association of favorable outcome with MAP group, controlling for illness category (surgical-cardiac vs. other), shockable rhythm, weekend/night arrest, age, CPR duration, and clustering by site. Results: 787 patients were included: median [Q1,Q3] age 17.9 [4.8,90.6] months; male 58%; OHCA 21%; shockable rhythm 13%; CPR duration 7 [3,16] min; favorable neurologic outcome 54%. Median lowest documented MAP percentile for the favorable outcome group was 13 [3,43] versus 8 [1,37] for the unfavorable group. The distribution of blood pressures by MAP group was I: 37%, II: 28%, III: 13%, IV: 11%, V: 7%, and VI: 4%. Compared with patients in Group I (< 5%ile), those in Groups II, III, and IV had significantly higher odds of favorable outcome (aOR, 1.84 [95% CI, 1.24, 2.73]; 2.20 [95% CI, 1.32, 3.68]; 1.90 [95% CI, 1.12, 3.25]). There was no statistically significant association between Groups V or VI and favorable outcome (aOR, 1.44 [95% CI, .75, 2.80]; 1.11 [95% CI, .47, 2.59]). Conclusions: In the first 6-hours post-return of spontaneous circulation (ROSC) after pediatric cardiac arrest, a lowest documented MAP >5th percentile (specifically 5th to 74th percentile) is associated with better neurologic outcomes." @default.
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• W4313222433 date "2022-12-15" @default.
• W4313222433 modified "2023-09-30" @default.
• W4313222433 title "1168: ASSOCIATION OF BLOOD PRESSURE WITH NEUROLOGIC OUTCOME AFTER PEDIATRIC CARDIAC ARREST RESUSCITATION" @default.
• W4313222433 doi "https://doi.org/10.1097/01.ccm.0000910408.82405.3e" @default.
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