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Vol. 42. Issue 6.
Pages 601 (June 2023)
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Out-of-hospital cardiac arrest in children
Paragem cardíaca extra-hospitalar em crianças
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José Carlos Areias
UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal
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To the Editor:

Out-of-hospital cardiac arrest is defined as the loss of mechanical function of the heart along with the absence of systematic circulation outside of a hospital setting.1

Unfortunately many cases occur in the absence of emergency medical services, an important reason for the low survival rate.

In the USA, 2–6% of all cases are in pediatric age-groups, and survival rates are 6–13%. In Japan the survival rate is 17–19%, although it is higher than in adults.

A paper analyzing one-month survival after pediatric out-of-hospital cardiac arrest reveals a lower survival rate following cardiac arrest at night compared with daytime or evening.2 The location of pediatric cardiac arrest has an important influence on overall prognosis and neurological sequelae.

De Maio et al. suggest that trauma accounts for almost one third of pediatric out-of-hospital cardiac arrests.3

Rapid and effective initiation of basic life support improves survival, and, if administered, more than eight out of 10 children transported to the hospital by emergency medical services experience return of spontaneous circulation.3

In conclusion, pediatric out-of-hospital cardiac arrest usually has a negative outcome, albeit less often than in adults. Early cardiopulmonary resuscitation and defibrillation have the greatest impact on return of spontaneous circulation and survival. However, overall prognosis and neurological outcome are relatively poor, emphasizing the need to mitigate sequelae.

Conflicts of interest

The author has no conflicts of interest to declare.

References
[1]
A. Sanati, A.A. Jaberi, T.N. Bonabi.
High school basic life support training: is the trainer's experience of cardiopulmonary resuscitation in the actual setting important? A randomized control trial.
J Educ Health Promot, 11 (2022), pp. 165
[2]
T. Fukuda, N. Ohashi-Fukuda, H. Sekiguchi, et al.
Survival from pediatric out-of-hospital cardiac arrest during nights and weekends: an updated Japanese registry-based study.
JACC: Asia, 2 (2022), pp. 433-443
[3]
V.J. De Maio, M.H. Osmond, I.G. Stiell, et al.
Epidemiology of out-of hospital pediatric cardiac arrest due to trauma.
Prehosp Emerg Care, 16 (2012), pp. 230-236
Copyright © 2023. Sociedade Portuguesa de Cardiologia
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