Evidence map›Paper›PMID 41270996›Full record

ArticleResuscitation2025

Timing and mode of death after pediatric in- and out-of-hospital cardiac arrest: a single center retrospective study.

Megan L McSherry, Kathryn Graham, Charlotte Z Woods-Hill, Jeremy R Herrmann, Matthew P Kirschen, Jessica C Fowler, Monique M Gardner, Ryan W Morgan, Robert M Sutton, Alexis Topjian

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Resuscitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Megan L McSherryDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: mcsherrym@chop.edu.
Kathryn GrahamDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: GrahamK1@chop.edu.
Charlotte Z Woods-HillDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: WOODSHILLC@chop.edu.
Jeremy R HerrmannDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: herrmannj1@chop.edu.
Matthew P KirschenDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States; Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: KIRSCHENM@chop.edu.
Jessica C FowlerDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: FowlerJ@chop.edu.
Monique M GardnerAnesthesia and Critical Care Medicine, Pediatrics University of Pennsylvania Perelman School of Medicine Division of Cardiac Critical Care, Children's Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: GardnerM@chop.edu.
Ryan W MorganDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: MorganR1@chop.edu.
Robert M SuttonDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: SUTTONR@chop.edu.
Alexis TopjianDepartment of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, 34th and Civic Center Blvd, Philadelphia, PA 19104, United States. Electronic address: topjian@chop.edu.

Funding

Physician Postdoctoral Research Training in Perioperative Medicine (PPRTPM)T32GM112596 · NIGMS · UNIVERSITY OF PENNSYLVANIA · PI Roderic G Eckenhoff, Max Kelz · 2015 to 2026
$3.4M
Pulmonary Hypertension-Associated Pediatric Cardiac ArrestK23HL148541 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI MORGAN, RYAN WILLIAM · 2020 to 2024
$791k
NHLBI NIH HHS K23 HL148541NICHD NIH HHS L40 HD119835NIGMS NIH HHS T32 GM112596
6 · The paper itself

Abstract

aimsTo characterize and compare modes of death and reasons for withdrawal of life-sustaining therapies (WLST) in children admitted to an intensive care unit (ICU) after in-hospital cardiac arrest (IHCA) or out-of-hospital cardiac arrest (OHCA).

methodsSingle center retrospective study of children who experienced IHCA or OHCA, were admitted to an ICU from January 2017 to March 2023, and died prior to discharge. Modes of death were classified as: a) death by neurologic criteria (DNC), b) WLST, c) recurrent arrest with attempted resuscitation ("recurrent arrest") or d) recurrent arrest without attempted resuscitation ("recurrent arrest/DNAR").

resultsOf 746 patients receiving post-arrest care, 260 non-survivors were analyzed. Of 155 IHCA patients, mode of death was DNC 8 (5%), WLST 87 (56%), recurrent arrest 33 (21%), recurrent arrest/DNAR 27 (18%). The primary reason for WLST was poor cardiovascular prognosis (WLST-CV) (40/87 [46%]). Of 105 OHCA patients, mode of death was DNC 51 (49%), WLST 38 (36%), recurrent arrest 8 (7.5%), recurrent arrest/DNAR 8 (7.5%). The primary reason for WLST was poor neurologic prognosis (WLST-N) (32/38 [84%]). Compared to OHCA patients, children with IHCA were less likely to die from DNC (p < 0.001) and more often underwent WLST-CV (p < 0.001). The median time to death was longer for IHCA vs. OHCA (5 [0.8,30] vs 3 [1.5,6] days, p = 0.03).

conclusionsFollowing an IHCA, non-survivors more frequently died from circulatory failure, including WLST-CV or recurrent arrest, while OHCA non-survivors more frequently died from neurologic injury, including DNC and WLST-N. Children who had an IHCA died later after their arrest than those who had an OHCA.

Indexed as

Cardiopulmonary ResuscitationHeart ArrestOut-of-Hospital Cardiac ArrestWithholding TreatmentAdolescentCause of DeathChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesTime FactorsCardiorespiratory failureDeath by neurologic criteriaLimitations of interventionsPediatric cardiac arrestPrognosticationWithdrawal of life-sustaining therapies

Identifiers

PMID41270996
PMCPMC12742292

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.