Author Affiliation: Department of Pediatrics, University of Washington School of Medicine, Children's Hospital, Seattle.
In this issue of JAMA, Nadkarni and colleagues1 compare the outcomes of pediatric and adult in-hospital cardiac arrests in the National Registry of Cardiopulmonary Resuscitation (NRCPR). In this largest pediatric inpatient cohort reported, the survival rate for children (27%) was higher than for adults (18%), with similar neurological outcomes for survivors, primarily due to better outcome in those patients with asystole. The initial pulseless rhythm proved the independent predictor of the outcome. Why compare adult and pediatric arrests? For decades, pediatric resuscitation has focused on the etiology of the arrest, which in children is most commonly respiratory. Adult resuscitation has focused on cardiac rhythm, which often is ventricular fibrillation (VF). This difference has formed the basis of 2 very different approaches to cardiac arrest care, training emphasis, and development and use of technologies. The results of Nadkarni et al raise the issue as to whether approaches for pediatric and adult resuscitation should differ.
Quan L. Adult and Pediatric ResuscitationFinding Common Ground. JAMA. 2006;295(1):96–98. doi:10.1001/jama.295.1.96