The physiologic response to epinephrine and pediatric cardiopulmonary resuscitation outcomes

Table 4 Sensitivity analysis of thresholds of change in DBP and patient outcomes

DBP threshold	Patients meeting threshold (n = 147)	ROSC		Survival to hospital discharge		Survival with favorable neurologic outcome*
DBP threshold	Patients meeting threshold (n = 147)	aRR	p value	aRR	p value	aRR	p value
≥ 0 mmHg	98 (66.7%)	1.35 (0.97, 1.87)	0.075	1.10 (0.81, 1.49)	0.549	1.08 (0.79, 1.47)	0.634
≥ 5 mmHg	66 (44.9%)	1.60 (1.21, 2.12)	0.001	1.12 (0.85, 1.47)	0.428	1.09 (0.82, 1.44)	0.560
≥ 10 mmHg	41 (27.9%)	1.59 (1.23, 2.05)	< 0.001	1.41 (1.07, 1.86)	0.013	1.35 (1.01, 1.79)	0.041
≥ 15 mmHg	30 (20.4%)	1.63 (1.27, 2.08)	< 0.001	1.63 (1.23, 2.17)	< 0.001	1.53 (1.13, 2.07)	0.005
≥ 20 mmHg	20 (13.6%)	1.45 (1.08, 1.96)	0.015	1.37 (0.92, 2.04)	0.125	1.35 (0.89, 2.06)	0.158

DBP diastolic blood pressure, ROSC return of spontaneous circulation, Arr adjusted relative risk
*Favorable neurologic outcome was defined as no more than moderate disability or no worsening from baseline Pediatric Cerebral Performance Category (PCPC). Baseline PCPC represents subject status prior to the event leading to hospitalization
Sensitivity analysis exploring potential thresholds for the change in DBP in response to epinephrine and outcomes utilizing Poisson regression model with robust error estimates. Model controlled for a priori specified covariates hypothesized to be associated with both the DBP response and outcomes: initial CPR rhythm (bradycardia and poor perfusion versus pulseless rhythms); illness category (medical cardiac, medical non-cardiac, surgical cardiac, surgical non-cardiac); presence of a vasopressor infusion at the start of CPR; and preexisting pulmonary hypertension

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