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Table 2 Cardiac arrest event characteristics by epinephrine response

From: The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes

 

Overall (n = 147)

Epinephrine responders (n = 66)

Epinephrine non-responders (n = 81)

P

Location of CPR event

   

 < 0.001

 PICU

46 (31.3%)

31 (47.0%)

15 (18.5%)

 

 CICU

101 (68.7%)

35 (53.0%)

66 (81.5%)

 

Interventions in place

 Central venous catheter

119 (81.0%)

52 (78.8%)

67 (82.7%)

0.673

 Vasoactive infusion

102 (69.4%)

45 (68.2%)

57 (70.4%)

0.858

 Invasive mechanical ventilation

120 (81.6%)

53 (80.3%)

67 (82.7%)

0.831

 Non-invasive ventilation

15 (10.2%)

8 (12.1%)

7 (8.6%)

0.587

Immediate cause(s) of arrest

 Arrhythmia

23 (15.6%)

10 (15.2%)

13 (16.0%)

1.000

 Cyanosis without respiratory decompensation

7 (4.8%)

3 (4.5%)

4 (4.9%)

1.000

 Hypotension

101 (68.7%)

46 (69.7%)

55 (67.9%)

0.859

 Respiratory decompensation

67 (45.6%)

31 (47.0%)

36 (44.4%)

0.868

Timing of CPR event*

   

0.150

 Weekday

90 (61.2%)

46 (69.7%)

44 (54.3%)

 

 Weeknight

32 (21.8%)

12 (18.2%)

20 (24.7%)

 

 Weekend

25 (17.0%)

8 (12.1%)

17 (21.0%)

 

First documented rhythm

   

0.706

 Asystole/PEA

51 (34.7%)

25 (37.9%)

26 (32.1%)

 

 VF/pulseless VT

11 (7.5%)

4 (6.1%)

7 (8.6%)

 

 Bradycardia with poor perfusion

85 (57.8%)

37 (56.1%)

48 (59.3%)

 

Duration of CPR (min)

11.0 [5.0, 29.0]

5.0 [3.0, 16.0]

20.0 [8.0, 41.0]

 < 0.001

Duration of CPR (min)

   

 < 0.001

  < 6

44 (29.9%)

34 (51.5%)

10 (12.3%)

 

 6–15

39 (26.5%)

14 (21.2%)

25 (30.9%)

 

 16–35

32 (21.8%)

12 (18.2%)

20 (24.7%)

 

  > 35

32 (21.8%)

6 (9.1%)

26 (32.1%)

 

Pharmacologic interventions during CPR

 Epinephrine

147 (100.0%)

66 (100.0%)

81 (100.0%)

 

  Minutes to first dose

2.0 [1.0, 3.0]

1.0 [1.0, 2.0]

2.0 [1.0, 3.0]

0.028

  Number of doses

2.0 [1.0, 5.0]

2.0 [1.0, 4.0]

3.0 [2.0, 5.0]

 < 0.001

  Average inter-dose interval†

4.5 [3.3, 8.0]

4.0 [3.0, 6.0]

4.8 [3.5, 9.3]

0.072

 Calcium

79 (53.7%)

28 (42.4%)

51 (63.0%)

0.020

 Sodium bicarbonate

91 (61.9%)

32 (48.5%)

59 (72.8%)

0.004

Pre-epinephrine BP (mmHg)

 Diastolic BP

34.3 [27.9, 45.5]

32.2 [28.5, 41.0]

37.2 [27.6, 46.6]

0.326

 Systolic BP

72.1 [52.5, 97.6]

70.7 [52.6, 86.7]

73.3 [52.3, 103.6]

0.327

 Adequate diastolic BP‡

113 (76.9%)

52 (78.8%)

61 (75.3%)

0.696

 Adequate systolic BP§

86 (58.5%)

36 (54.5%)

50 (61.7%)

0.399

Change in BP with epinephrine (mmHg)||

 Diastolic BP

4.4 [− 1.9, 11.5]

13.6 [7.5, 29.3]

− 1.5 [− 5.0, 1.5]

 < 0.001

 Systolic BP

11.4 [− 3.6, 25.8]

24.0 [11.5, 38.3]

1.4 [− 9.7, 14.1]

 < 0.001

  1. CPR cardiopulmonary resuscitation, PICU pediatric intensive care unit, CICU pediatric cardiac intensive care unit, PEA pulseless electrical activity, VF ventricular fibrillation, VT ventricular tachycardia, BP blood pressure
  2. *Weekday is between 7 a.m. and 11 p.m. Monday–Friday; weeknight is after 11 p.m. Monday–Thursday; Weekend is from 11 p.m. on Friday through 7 a.m. on the following Monday
  3. †Event-level average interval between epinephrine doses calculated among patients who received at least two doses of epinephrine
  4. ‡Average diastolic BP prior to first dose of epinephrine of ≥ 25 mmHg for age < 1 year or ≥ 30 mmHg for age ≥ 1 year
  5. §Average systolic BP prior to first dose of epinephrine ≥ 60 mmHg for age < 1 year or ≥ 80 mmHg for age ≥ 1 year
  6. ||Difference in BP from the 30-s data epoch prior to the minute in which the first dose of epinephrine was administered to the average of the four 30-s data epochs following the minute in which epinephrine was administered
  7. Epinephrine responders (patients with ≥ 5 mmHg increase in DBP following the first dose of epinephrine administered during cardiopulmonary resuscitation) and epinephrine non-responders compared using Fisher’s exact test for categorical data and Wilcoxon rank-sum test for continuous data
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Critical Care

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