ABSTRACT

The characteristics, prognostic factors and early outcomes were evaluated for children receiving advanced life support in emergency department.

We retrospectively evaluated the medical records of 46 children who received advanced life support in emergency department between 06. 01.2011 –05. 31.2012. The clinical and laboratory variables that were available at admission and the predictors of mortality in first 24 hours were analyzed.

The incidence of advanced life support was %0,03. Sixteen of them were trauma patients and 21 children had chronic disease. Among the 46 children who received advanced life support, 15 patients were died in first 24 hours. The median age of patients who died and survived were 8 and 30 months (p<0.05). The number of epinephrine injections, the blood levels of glucose, C-reactive protein, bicarbonate, base excess and lactate were significantly different between the survived and death patients in first 24 hours (p<0,05). In logistic regression analysis, the higher numbers of epinephrine injections and higher levels of blood lactate level were identified as predictors of early mortality (p<0.05). The areas under the curve of number of epinephrine injection and blood lactate level were 0.900 and 0.883 in ROC analysis.

The number of epinephrine injection and blood lactate level at arrival to the emergency department are the predictors of death in first 24 hours.

Keywords: Advanced life support, pediatric emergency department, epinephrine, lactate