Predictors of successful resuscitation in non-trauma dead-on-arrival children

Background: Dead-on-arrival (DOA) children pose difficult challenges in resuscitation because of the very low survival rate. In this study, we aimed to analyze the factors that may be related to predicting successful cardiopulmonary resuscitation (CPR). Methods: We reviewed the hospital records of 120 DOA children aged younger than 18 years who had been admitted to the emergency department (ED) from 2000 to 2004 and analyzed related factors that may have influenced initial CPR in the non-trauma DOA children. Survival analysis was used to compare differences in survival rate between the non-trauma and trauma DOA children. Receiver operating characteristic (ROC) analysis was used to determine the predictive in-hospital CPR duration related to success of initial CPR. Results: We found the initial cardiac rhythm (P=0.007), pre-hospital basic life support (BLS) (P <0.001), mode of transportation (P=0.019), the period from scene to hospital (P=0.025) and the duration of pre-hospital BLS (P=0.003) were the significant factors related to initial successful CPR in non-trauma DOA children. Based on the ROC analysis, the cutoff value of in-hospital CPR duration was 23 minutes in non-trauma DOA children. Conclusions: We found that in-hospital CPR should be performed for at least 23 minutes in non-trauma DOA children for spontaneous circulation to return.