Observational studyResuscitation2024
Association of blood pressure with neurologic outcome at hospital discharge after pediatric cardiac arrest resuscitation.
Observational study in Resuscitation, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- The impacts of blood pressure variability on clinical outcomes in patients with out-of-hospital cardiac arrest.Resuscitation plus · 2025Article
- The Latest in Resuscitation Research: Highlights From the 2024 American Heart Association's Resuscitation Science Symposium.Journal of the American Heart Association · 2025Article
- Association Between Deviations From Cerebral Autoregulation-Derived Optimal Blood Pressure and Outcome After Pediatric Cardiac Arrest.Neurology · 2025Article
- A Dutch nationwide pediatric cardiac arrest registry with long-term follow-up - towards an international prognostication guideline.Resuscitation plus · 2025Article
- The association between early hypotension and neurologic outcome after pediatric cardiac ECPR in children with cardiac disease.Resuscitation plus · 2024Article
- The association between initial post-resuscitation diastolic blood pressure and survival after pediatric cardiac arrest: a retrospective study.BMC pediatrics · 2024Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundPoor outcomes are associated with post cardiac arrest blood pressures <5th percentile for age. We aimed to study the relationship of mean arterial pressure (MAP) with favorable neurologic outcome following cardiac arrest and return of spontaneous circulation (ROSC).
methodsThis retrospective, multi-center, observational study analyzed data from the Pediatric Resuscitation Quality Collaborative (pediRES-Q). Children (<18 years) who achieved ROSC following index in-hospital or out-of-hospital cardiac arrest and survived ≥6 hours were included. Lowest documented MAP within the first 6 hours of ROSC was percentile adjusted for age and categorized into six groups - Group I: <5th, II: 5-24th, III: 25-49th, IV: 50-74th, V: 75-94th; and VI: 95-100th percentile. Primary outcome was favorable neurologic status at hospital discharge, defined as PCPC score 1, 2, or no change from pre-arrest baseline. Multivariable logistic regression was performed to analyze the association of MAP group with favorable outcome, controlling for illness category (surgical-cardiac), initial rhythm (shockable), arrest time (weekend or overnight), age, CPR duration, and clustering by site.
results787 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), Groups II, III, and IV had 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 association between Groups V or VI and favorable outcome (aOR, 1.44 [95% CI, 0.75, 2.80]; 1.11 [95% CI, 0.47, 2.59]).
conclusionIn the first 6-hours post-ROSC, a lowest documented MAP between the 5th-74th percentile for age was associated with favorable neurologic outcome compared to MAP <5th percentile for age.
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