Incidence and Prognosis of Acute Kidney Injury After Cardiac Arrest in Children.

BACKGROUND/AIMS: The incidence of acute kidney injury (AKI) after cardiac arrest (CA) in adults is associated with a high mortality, but there are few data about the incidence and prognosis of AKI after CA in children. The aim of our study was to analyze the incidence of AKI in children who have experienced an in-hospital CA and its association with mortality. METHODS: A retrospective observational study in a prospective database was performed including children between the ages 1 month and 16 years, who had undergone an in-hospital CA. Information on clinical, analytical, and monitorization data, treatment, mortality and cause of death were recorded. RESULTS: Fifty-six children were included in the study (57.6% males). Return of spontaneous circulation (ROSC) was achieved in 49 children (87.7%). Thirty-one patients (55.3%) survived. Four patients (8.1%) were being treated with continuous renal replacement therapies (CCRT) before CA. After ROSC, 7 other children (14.3%) had severe acute kidney injury requiring CRRT. Mortality of children who required CRRT after CA (57.1%) was not significantly higher than that in children who did not (26.3%; p = 0.18). But mortality of patients who need CRRT before or after CA (72.7%) was significantly higher than the remaining patients (26.3%; p = 0.03). CONCLUSIONS: The frequency of AKI in children after recovering a CA is moderate. AKI that needs CCRT before or after CA is associated with a higher mortality.

Incidence and prognosis of nosocomial infection after recovering of cardiac arrest in children.

OBJECTIVE: to analyze the incidence of infection in children who have suffered an in-hospital cardiac arrest (CA) and the association with mortality. METHODS: A retrospective unicenter observational study on a prospective database with children between one month and 16 years old, who have suffered an in-hospital CA was performed. Clinical, analytical and monitorization data, treatment, mortality and cause of death were recorded. RESULTS: 57 children were studied (57.6% males). Recovery of spontaneous circulation (ROSC) was achieved in 50 children (87.7%) and 32 (59.3%) survived. After ROSC, 28 patients (56% of those who achieved ROSC) were diagnosed of infection. There were not significant differences in mortality between patients infected (42.9%) and uninfected (27.3%) p=0.374. Only one died in consequence of a sepsis with multiorganic failure. CONCLUSIONS: The frequency of infection in children after recovering of a cardiac arrest is high. There were no statistically significant differences in mortality between patients with and without infection after ROSC.