Pediatric anesthesia & critical care
Impaired echocardiographic left ventricular global longitudinal strain after pediatric cardiac arrest children is associated with mortality
Main finding · Hospital mortalityResult — go to the resultAdjusted odds ratio per 1% increase in GLS 1.17 95% CI 1.09–1.26Authors' conclusion
Impaired LV function as measured by GLS after pediatric cardiac arrest is associated with hospital mortality. GLS is a novel complementary metric to traditional post-arrest echocardiography that correlates strongly with EF and SF and is associated with mortality.
Study context
- Population
- Children <18 years treated in the pediatric intensive care unit (PICU) after IHCA or OHCA, with echocardiogram within 24 hours of post-arrest PICU care, 2013–2020; congenital heart disease, post-arrest extracorporeal support or unmeasurable global longitudinal strain (GLS) excluded
- Participants
- 124 children
- Exposure
- Impaired vs normal left ventricular (LV) GLS after paediatric cardiac arrest
- Impaired GLSn = 46
- Outcome
- Frequency of impaired GLS and its association with hospital mortality
Methodological detailssingle-centre, GLS measured post hoc
- Single-centre
- GLS measured post hoc
Main finding
Hospital mortality
Adjusted odds ratio per 1% increase in GLS
1.17
95% CI 1.09–1.26
P < 0.001
As reported in the abstract
- Impaired GLS present
- 46 (37.1%)
Observational data: associations, not effects.
Further findings
Baseline characteristics by GLS group
VT/VF initial rhythm Impaired GLS 19.6% · Normal GLS 3.8%
Peak troponin first 24 h (median) Impaired GLS 2.5 · Normal GLS 0.5
EF and SF by GLS group
Median EF
Median SF
- Ejection fraction (EF) and shortening fraction (SF) by GLS group — Correlation GLS vs EF (rho)
- −0.76
- EF and SF by GLS group — Correlation GLS vs SF (rho)
- −0.71
- Discrimination for mortality (area under the receiver operator curve (AUROC)) — Similar discrimination for mortality
- p = 0.101
- Baseline characteristics by GLS group: age p < 0.001
- Baseline characteristics by GLS group: VT/VF p = 0.017
- Baseline characteristics by GLS group: troponin p = 0.002
- EF and SF by GLS group: all p < 0.001
- Discrimination for mortality (AUROC): GLS AUROC 0.69 (95% CI 0.60–0.79)
- Discrimination for mortality (AUROC): EF AUROC 0.71 (95% CI 0.58–0.88)
- Discrimination for mortality (AUROC): SF AUROC 0.71 (95% CI 0.61–0.82)
Baseline characteristics by GLS group
- No differences in arrest location or CPR duration by GLS group
Original publication
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