Pediatric Obesity Affects Survival After In-Hospital CPR

Further studies and guidelines needed to assess potential CPR differences in obese children
By Jeff Muise
HealthDay Reporter

MONDAY, Feb. 22 (HealthDay News) -- Obese children who undergo cardiopulmonary resuscitation (CPR) in the hospital are at greater risk of dying before hospital discharge than normal weight or underweight children, according to a study published online Feb. 22 in Pediatrics.

Vijay Srinivasan, M.D., of the Children's Hospital of Philadelphia, and colleagues reviewed 1,477 cases of pediatric CPR during hospitalization in 167 participating hospitals in the National Registry of Cardiopulmonary Resuscitation for the period 2000 to 2004. The researchers associated pediatric obesity or underweight to the primary outcome of survival to hospital discharge.

Of the 1,268 children included in the analysis, 213 (17 percent) were obese, 571 (45 percent) were underweight, and 484 (38 percent) were normal weight. In-hospital CPR quality was generally deemed of worse quality in obese children due to problems establishing an airway, less effective chest compressions, and dosing uncertainty for pediatric advanced life support medications. The researchers found that obesity was independently associated with diminished odds of event survival (odds ratio, 0.58) and survival to hospital discharge (odds ratio, 0.62) after in-hospital CPR, compared to normal weight children. No association was seen between underweight and worse outcomes.

"Childhood obesity is associated with a lower rate of survival to hospital discharge after in-hospital, pediatric CPR. Future pediatric CPR investigations and guidelines may need to address potential differences in CPR and advanced life support for obese children," the authors write.

Several study authors reported receiving grant support or consulting fees from pharmaceutical and medical device companies in the pediatric market.

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