Langeveld, R.J. (Robert) (2015) Survival following cardiac arrest in the neonatal intensive care unit. thesis, Medicine.
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Abstract
Introduction. Resuscitations performed in neonatal intensive care units (NICUs) are sparsely studied, in contrast to resuscitation in delivery rooms and paediatric intensive care units (PICUs), where it is shown that duration of resuscitation, location of arrest, age, heart rhythm, and medications administered affect survival. Outcomes of resuscitation and variables that affect outcome might be different in the NICU, because the pathophysiology of the patients is different than in delivery rooms or PICUs. The objectives of this study are to quantify and characterize in-unit resuscitations in a referral NICU and to identify the infant and event characteristics associated with survival after these resuscitations. Methods. A retrospective cohort study of resuscitations performed from January 1, 2011 to June 30, 2015, in the NICU of the Children’s Hospital of Philadelphia (CHOP). Eligible patients were identified from CHOP Resuscitation database. Data was abstracted from several resuscitation databases. Survival to hospital discharge was our outcome. Relations between outcome and patient/resuscitation-related variables were examined with multivariable logistic regressions. Results. During the study period, 94 first time events treated with chest compressions were abstracted from the database. Median duration of chest compression was 2 minutes, with outliers at 52 minutes. Multivariate analysis showed low pH prior to event, blood pressure support medication before the event and epinephrine administration during resuscitation being associated with mortality. Conclusion. Resuscitation in infants at referral NICUs is rare and has a low mortality. Results are still hypothesis generating and further studies are needed to identify methods to improve survival.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Bos, Arend F MD |
| Supervisor name: | External supervisor: and Foglia, Elizabeth MD and Division of Neonatology and The Children’s Hospital of Philadelphia |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:53 |
| Last Modified: | 25 Jun 2020 10:53 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1357 |
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