Physician-researchers from the Cardiac Center at The Children’s Hospital of Philadelphia presented new findings on pediatric cardiovascular disease at the American Heart Association’s Scientific Sessions 2015 in Orlando, Fla. Among many studies presented, two of the most notable were abstracts on CPR performed outside of hospitals on infants and adolescents, and the long-term risk of liver disease in survivors of surgery for complex congenital heart disease.
Bystander CPR for children with out-of-hospital cardiac arrest
While bystander cardiopulmonary resuscitation (CPR) is linked to better outcomes in adults who have cardiac arrests outside of hospitals, little is known about the prevalence and impact of such CPR in children in the U.S. Dr. Maryam Y. Naim and colleagues analyzed a national registry of 2,176 pediatric cardiac arrests, primarily in children and adolescents, in 2013 and 2014.
Watch Dr. Naim's Medscape video presentation about the study »
Of the cardiac arrests, 86 percent occurred at home, and 71 percent of the bystanders who performed CPR were family members. In nearly 50 percent of pediatric cases, bystanders provided CPR, yielding a higher overall rate of neurologically favorable survival—in 11 percent of cases, compared to 7 percent when CPR was not performed. Survival rates were strikingly higher in out-of-home arrests.
The authors suggest that public health strategies should aim to improve the use of CPR by bystanders, with special attention to improving bystander CPR techniques for infants.
Risk factors for liver disease in survivors of Fontan operation
Hepatic fibrosis, a condition in which scar tissue forms in the liver, is increasingly recognized as a long-term consequence of the circulation created by the Fontan operation. This study provided cross-sectional data on the degree of hepatic fibrosis in a cohort of 67 predominantly asymptomatic children and adolescents at a mean time of 15 years after the Fontan operation. Dr. David Goldberg and colleagues report that while it is hard to find lab tests that correlate with the degree of fibrosis, an increasing duration of time after the Fontan operation is associated with an increasing burden of fibrosis. This study has important implications for how patients who have had the Fontan operation are monitored as they get older.