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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Diagram showing the inclusion of patients and final outcome&#46; EAWP&#58; electrical activity without a pulse&#59; CPC&#58; Cerebral Performance Category&#59; CPR&#58; cardiopulmonary resuscitation&#59; RSC&#58; recovery of spontaneous circulation&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">While once considered a rare event&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">1</span></a> out-of-hospital cardiac arrest &#40;CA&#41; in the pediatric population currently holds a relevant place in this type of disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">2&#44;3</span></a> Nevertheless&#44; in comparison with CA in the adult population&#44; the available information referred to pediatric patients is scarce&#46; Some series have presented a significant number of patients&#44; analyzing the incidence of the disease at population level and the outcomes referred to survival and neurological status at hospital discharge&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">4</span></a> However&#44; there is controversy regarding the long-term outcomes in terms of pediatric patient recovery&#46; This situation is due to the few data available on neurological recovery in periods late after discharge from hospital&#46; The most important series do not explore beyond neurological status one month after the event&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">5&#44;6</span></a> On the other hand&#44; pediatric age has not been clearly defined in the literature on CA&#44; and in this regard the incidence and final outcomes vary greatly according to the different age intervals considered&#46; The age range involved therefore needs to be specified&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">5&#44;7</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The present study describes the long-term outcomes in terms of survival and neurological status in patients between 0 and 15 years who suffer out-of-hospital CA&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Patients and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">A retrospective observational study was made between January 2008 and December 2012&#44; based on data obtained from the Andalusian Out-of-Hospital Cardiac Arrest Registry &#40;<span class="elsevierStyleItalic">Registro Andaluz de Parada Card&#237;aca Extrahospitalaria</span>&#41;&#44; the protocols of which have been described elsewhere&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> In brief&#44; this is a continuous registry of cases of out-of-hospital CA assisted by the emergency care teams &#40;ECTs&#41; of the Public Company of Healthcare Emergencies of Andalusia &#40;Spain&#41;&#40;<span class="elsevierStyleItalic">Empresa P&#250;blica de Emergencias Sanitarias de Andaluc&#237;a</span>&#44; EPES&#41;&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Setting</span><p id="par0020" class="elsevierStylePara elsevierViewall">As a public service&#44; the EPES manages out-of-hospital healthcare emergencies throughout Andalusia&#46; However&#44; due to its socio-geographic structure&#44; the resources and care dedicated to out-of-hospital emergencies by the EPES result in overland coverage of 67&#37; of the population&#44; and mixed air and overland coverage of 100&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">9&#44;10</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Patients studied</span><p id="par0025" class="elsevierStylePara elsevierViewall">When dealing with ventricular fibrillation or when performing resuscitation maneuvers&#44; the ECTs use codes 427&#46;41 &#40;ventricular fibrillation&#41; and 427&#46;5 &#40;CA&#41; to typify the care provided&#46; All cases with these codes are automatically entered in the registry&#46; The pre-hospital care parameters are documented in each case&#58; patient information &#40;gender&#44; age&#41;&#44; the context of CA &#40;place where CA occurs&#44; whether the event was witnessed or not&#44; prior life support measures with or without defibrillation&#44; time intervals from event to call&#47;arrival of the ECT&#41;&#44; ECT interventions &#40;airway maintenance&#44; defibrillation&#44; drugs&#44; condition at end of resuscitation&#44; estimated cause of arrest&#41;&#44; hospital evolutive parameters &#40;coronary intervention&#44; hypothermia&#44; survival and neurological status at discharge&#41;&#44; and follow-up data at discharge &#40;survival and neurological status at discharge&#41;&#46; The hospital data were consulted from the single &#40;unified&#41; patient case history&#46; Follow-up after discharge&#44; at one month and one year&#44; is made by means of a standardized telephone survey&#44; centralized for all Andalusia&#44; and carried out from an EPES coordination center&#46; Consent is requested from the patient &#40;or relatives &#8211; in this case always the parents&#41; for both the interview and for statistical use of the data&#46; Evaluation of neurological status was based on the pediatric Cerebral Performance Category &#40;CPC&#41; scale&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">11</span></a> In order to limit the loss of information and loss of number of cases&#44; an annual request is made for access to the National Mortality Statistics Institute of the Spanish Ministry of Health&#46; Lastly&#44; for the present analysis&#44; special follow-up was conducted during the month of May 2014&#46; This follow-up determined the maximum evolution time of each patient&#46; The definition of the selected variables &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; follows the Utstein recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">12</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Inclusion criteria</span><p id="par0030" class="elsevierStylePara elsevierViewall">The present study considered the pediatric patients included in the registry and aged between 0 and 15 years &#40;both included&#41;&#46; Futile resuscitation cases were excluded to the effects of analysis&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0035" class="elsevierStylePara elsevierViewall">A descriptive analysis was made of the general characteristics&#44; the pre-hospital care provided&#44; and the characteristics of the survivors&#46; The results are expressed as the mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation&#44; median and interquartile range&#44; or as the number and percentage&#44; as applicable&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0040" class="elsevierStylePara elsevierViewall">The registry comprised a total of 5069 patients subjected to advanced life support care&#46; Of these individuals&#44; 125 &#40;2&#46;5&#37;&#41; were 15 years old or younger &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A total of 113 CA events &#40;90&#46;4&#37;&#41; occurred before arrival of the ECT&#46; The exact timing of the event could not be established in 50 cases &#40;44&#46;2&#37;&#41;&#44; i&#46;e&#46;&#44; the interval could only be calculated in 63 &#40;55&#46;8&#37;&#41;&#46; The general characteristics of the patients are reported in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The details referred to pre-hospital care and the outcomes following such care are described in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; None of the patients admitted to hospital received treatment involving hypothermia&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Of the 9 patients &#40;7&#46;2&#37;&#41; alive at hospital discharge&#44; 5 experienced full recovery &#40;CPC<span class="elsevierStyleInf">1</span>&#41;&#44; while four suffered severe neurological sequelae &#40;CPC<span class="elsevierStyleInf">3&#8211;4</span>&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The following results were recorded over follow-up&#58; the 5 patients with CPC<span class="elsevierStyleInf">1</span> maintained this status 18&#44; 22&#44; 42&#44; 58 and 62 months after the event&#44; respectively&#46; The four patients with CPC<span class="elsevierStyleInf">3&#8211;4</span> neurological impairment were alive and presented discrete improvement of their neurological status &#40;all four corresponded to CPC<span class="elsevierStyleInf">3</span>&#41; after a period of 6&#44; 8&#44; 24 and 45 months&#44; respectively&#46; The characteristics of these patients are described in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The present study describes the results of the largest series of out-of-hospital CA episodes in the pediatric population in Spain&#46; The proportion of pediatric&#47;adult CA in our series is similar to that published by other registries&#44; taking into account the differences in defining the age groups&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">3&#44;6</span></a> Likewise&#44; overall survival was consistent with the data from other similar series&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">13</span></a> and lower than in our adult population&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">8</span></a> Most of the CA episodes occurred outside the home&#44; though close to 50&#37; were not witnessed&#46; Despite these data&#44; resuscitation maneuvers were started in two-thirds of the cases before the arrival of the ECT&#8211;probably because a proportion of arrests occurred in primary care centers and others were directly referred to these centers before the ECT arrived&#46; One-half of the patient reached the hospital&#44; though one out of every 5 of these individuals did so without a spontaneous pulse and under conditions of ongoing resuscitation maneuvering&#8211;this being known to imply a poor prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">14&#44;15</span></a> This circumstance&#44; which greatly exceeds what is seen in adults&#44; is probably related to the known difficulty of deciding resuscitation cessation in children&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">16</span></a> Although the time of death cannot be established&#44; the fact is that none of the patients with ongoing resuscitation maneuvering received hospital discharge&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">In the same way as in other series from different countries&#44; an initial defibrillable rhythm is infrequent&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">5&#44;17&#44;18</span></a> and this undoubtedly exerts an influence upon the low general survival rates observed at this age&#46; In fact&#44; asystolia was not the initial condition in any of the cases with a favorable neurological outcome&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">All the survivors underwent life support maneuvering before arrival of the ECT&#44; and CA was witnessed in the 5 cases resulting in full recuperation&#46; One arrest of traumatic origin was also witnessed by the ECT&#46; Although this patient survived&#44; long-term sequelae resulted &#40;CPC<span class="elsevierStyleInf">3</span>&#41;&#8211;this being expected&#44; considering the poor general prognosis of CA of this kind&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">19</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">An important number of cases were classified as being of unknown cause&#44; and although in adults CA is usually attributed to cardiac causes&#44; the same does not apply to pediatric patients&#44; where a low diagnostic correlation has been evidenced in the absence of an apparent cause of CA&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">20</span></a> There was moreover important uncertainty in estimating the time of arrest &#8211; this reflecting the difficulty of establishing the time of the event when CA is not witnessed&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Survival among out-of-hospital CA victims is low&#46; Although a significant percentage of patients reach hospital&#44; the long-term outcome is disappointing&#44; independently of adherence of the pre-hospital basic&#44; airway and drug measures &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41; to the international recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">21</span></a> The results are probably influenced by the difficulty of treating the cause of CA&#44; e&#46;g&#46;&#44; percutaneous coronary intervention in the case of CA of cardiac origin in adults&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">22</span></a> and uncertainty regarding the efficacy of therapeutic hypothermia in pediatric CA&#46;<a class="elsevierStyleCrossRefs" href="#bib0255"><span class="elsevierStyleSup">23&#44;24</span></a> In fact&#44; in none of the patients in our series was hypothermia used&#44; despite the fact that during the first years of this type of practice there were fewer negative data to feed such controversy&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">24</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">A very notorious observation is the marked difference in outcome between pediatric out-of-hospital CA and CA occurring in hospital&#44;<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">25</span></a> with percentage results that currently give the impression of being beyond reach&#46; Nevertheless&#44; considering that the data are referred to a single emergency care service &#40;albeit assisting the most populated region in Spain&#41;&#44; there might be some variability&#44; as occurs with other general series published in this country&#46;<a class="elsevierStyleCrossRef" href="#bib0270"><span class="elsevierStyleSup">26</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">A key issue in intervention would be not only to increase the percentage of prior resuscitation maneuvering but also its quality &#8211; specifically&#44; performing chest compression with ventilation versus compression alone&#46; This aspect should be stressed when telephone recommendations and instructions are provided from the coordination centers&#46;<a class="elsevierStyleCrossRefs" href="#bib0275"><span class="elsevierStyleSup">27&#44;28</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Despite the abovementioned data&#44; the neurological status of the pediatric patients that survived out-of-hospital CA was maintained over the long term&#46; The patients discharged from hospital with full recovery maintained that condition&#46; In comparison&#44; although the patients with neurological sequelae showed discrete improvement&#44; they all remained dependent for daily life activities&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Our study has a number of limitations&#46; Although patients are entered prospectively in the registry&#44; in chronological order&#44; the data were analyzed on a retrospective basis&#46; Certain variables with missing information in turn can condition the results&#46; In this regard&#44; missing information referred to the time of arrest limits analysis of the influence of the time interval between collapse and the start of resuscitation&#46; Although this is a common limitation in most registries&#44; it constitutes a key variable in relation to the outcome of CA&#46; On the other hand&#44; the registry is characterized by an automatic case inclusion system&#44; and although quality control measures have been implemented&#44; it is not possible to discard errors attributable to defective case coding&#44; which would result in the non-inclusion of some patients&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Although the study series was very large considering the age group involved&#44; the small number of patients who finally survived did not advise any correlating analysis between variables and outcome&#46; Lastly&#44; this is a general CA registry&#44; not a specific registry of pediatric CA&#44; and is moreover confined to a regional setting&#46; The results obtained therefore might not be extendable to the rest of Spain&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Our results demonstrate the need to maintain follow-up and to analyze the evolution of pediatric patients with out-of-hospital CA&#44; in order to incorporate improvements in their integral care&#46; Research focusing on measures capable of guaranteeing previous resuscitation of better quality could increase the chances for success of a series of hospital care measures which&#44; at least for the time being&#44; lack protocols specifically targeted to patients of this age&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Financial support</span><p id="par0110" class="elsevierStylePara elsevierViewall">The Andalusian Out-of-Hospital Cardiac Arrest Registry &#40;<span class="elsevierStyleItalic">Registro Andaluz de Parada Card&#237;aca Extrahospitalaria</span>&#41; was implemented through a research grant from the <span class="elsevierStyleGrantSponsor" id="gs1"><span class="elsevierStyleItalic">Fondo de Investigaciones Sanitarias&#44; Instituto Carlos III</span></span>&#44; and is maintained through proprietary funding from the EPES&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflict of interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Little is known about the evolution and long-term neurological status of pediatric patients who survive out-of-hospital cardiac arrest&#46; Our aim is to describe long-term survival and neurological status&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Design</span><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Retrospective observational study&#44; based on the Andalusian Register of out-of-hospital Cardiac Arrest&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Setting</span><p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Pre-hospital Care&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Patients</span><p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">The study included patients aged 0&#8211;15 years between January 2008 and December 2012&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Interventions</span><p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Patients follow up&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Variables</span><p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Prehospital and hospital care variables were analyzed and one-year follow-up was performed&#44; along with a specific follow-up of survivors in June 2014&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Results</span><p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Of 5069 patients included in the register&#44; 125 &#40;2&#46;5&#37;&#41; were aged &#8804;15 years&#46; Cardiac arrest was witnessed in 52&#46;8&#37; of cases and resuscitation was performed in 65&#46;6&#37;&#46; The initial rhythm was shockable in 7 &#40;5&#46;2&#37;&#41; cases&#46; Nearly half &#40;48&#46;8&#37;&#41; the patients reached the hospital alive&#44; of whom 20&#37; did so while receiving resuscitation maneuvers&#46; Only 9 &#40;7&#46;2&#37;&#41; patients survived to hospital discharge&#59; 5 showed ad integrum recovery and 4 showed significant neurological impairment&#46; The 5 patients with complete recovery continued their long-term situation&#46; The remaining 4 patients&#44; although slight improvement&#44; were maintained in situation of neurological disability&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conclusions</span><p id="spar0120" class="elsevierStyleSimplePara elsevierViewall">Survival after out-of-hospital cardiac arrest in pediatric patients was low&#46; The long-term prognosis of survivors with good neurological recovery remains&#44; although improvement in the rest was minimal&#46;</p></span>"
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        "resumen" => "<span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Objetivo</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">No existe demasiada informaci&#243;n sobre la evoluci&#243;n y estado neurol&#243;gico a largo plazo de los pacientes en edad pedi&#225;trica que sobreviven a una parada cardiaca extrahospitalaria&#46; Nuestro objetivo es describir la supervivencia y estado neurol&#243;gico de estos pacientes a largo plazo&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Dise&#241;o</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional retrospectivo&#46; Basado en el Registro Andaluz de Parada Cardiaca Extrahospitalaria&#46;</p></span> <span id="abst0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">&#193;mbito</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Atenci&#243;n Prehospitalaria&#46;</p></span> <span id="abst0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Entre 0 y 15 a&#241;os atendidos entre enero de 2008 y diciembre de 2012 por Parada Cardiaca Extrahospitalaria&#46;</p></span> <span id="abst0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Intervenciones</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Seguimiento de pacientes&#46;</p></span> <span id="abst0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Se incluyen variables de la atenci&#243;n prehospitalaria&#44; hospitalaria y del seguimiento al a&#241;o y un seguimiento espec&#237;fico de los supervivientes en junio de 2014&#46;</p></span> <span id="abst0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron en el registro un total de 5069 pacientes de los que 125&#40;2&#46;5&#37;&#41; ten&#237;an 15 o menos a&#241;os&#46; La parada fue presenciada en el 52&#46;8&#37; de los casos y hubo reanimaci&#243;n previa en 65&#46;6&#37;&#46; El ritmo inicial fue desfibrilable en 7 &#40;5&#46;2&#37;&#41; casos&#46; Un 48&#46;8&#37; de los pacientes lleg&#243; al hospital aunque un 20&#37; lo hizo en situaci&#243;n de reanimaci&#243;n en curso&#46; De los 9 &#40;7&#46;2&#37;&#41; pacientes que sobrevivieron al alta hospitalaria&#44; 5 de ellos lo hicieron con recuperaci&#243;n ad integrum y 4 con grave deterioro neurol&#243;gico&#46; Los 5 pacientes con recuperaci&#243;n completa mantuvieron su situaci&#243;n a largo plazo&#46; Los 4 pacientes restantes&#44; aunque con discreta mejor&#237;a&#44; se mantuvieron en situaci&#243;n de discapacidad neurol&#243;gica&#46;</p></span> <span id="abst0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">La supervivencia de la parada cardiaca extrahospitalaria en edad pedi&#225;trica es baja&#46; El pron&#243;stico a largo plazo de los pacientes con buena recuperaci&#243;n neurol&#243;gica desde el inicio se mantiene&#44; aunque la mejor&#237;a en el resto es m&#237;nima&#46;</p></span>"
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            "identificador" => "abst0060"
            "titulo" => "Pacientes"
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            "identificador" => "abst0065"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Rosell-Ortiz F&#44; Mellado-Vergel FJ&#44; L&#243;pez-Messa JB&#44; Fern&#225;ndez-Valle P&#44; Ruiz-Montero MM&#44; Gonz&#225;lez-Lobato I&#44; et al&#46; Supervivencia y estado neurol&#243;gico de la parada cardiaca extrahospitalaria en edad pedi&#225;trica en Andaluc&#237;a&#46; Med Intensiva&#46; 2016&#59;40&#58;163&#8211;167&#46;</p>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Diagram showing the inclusion of patients and final outcome&#46; EAWP&#58; electrical activity without a pulse&#59; CPC&#58; Cerebral Performance Category&#59; CPR&#58; cardiopulmonary resuscitation&#59; RSC&#58; recovery of spontaneous circulation&#46;</p>"
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          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">SD&#58; standard deviation&#59; ECT&#58; emergency care team&#59; CA&#58; cardiac arrest&#59; CPR&#58; cardiopulmonary resuscitation&#59; IQR&#58; interquartile range&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Distribution&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age in years &#40;mean</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">&#177;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">SD&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Median &#40;IQR&#41; in years</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;1&#8211;9&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Males&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77 &#40;61&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Place of arrest&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Home&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;29&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Public place&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31 &#40;24&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Street&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Non-hospital medical center&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ambulance of the ECT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Witnessed arrest&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66 &#40;52&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Witnesses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38 &#40;30&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other healthcare personnel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;12&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>ECT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12 &#40;9&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Life support measures before arrival of the ECT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">82 &#40;65&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Healthcare personnel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;51&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Witnesses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;11&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Non-healthcare public service personnel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Witnesses with telephone CPR support&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2 &#40;1&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Defibrillations before arrival of the ECT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="char" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Cause of CA&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Traumatic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Respiratory&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22 &#40;17&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Not known&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">37 &#40;29&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20 &#40;16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Others&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;10&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Drowning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Toxic-metabolic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Neurological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Interval collapse-arrival ECT&#44; median &#40;IQR&#41; in minutes</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;9&#8211;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Interval call-arrival ECT&#44; median &#40;IQR&#41; in minutes</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;12&#8211;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Airway maintenance&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">OTI</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">110 &#40;88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Not performed</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">OTI before ECT</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">OTI before CA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Laryngeal mask</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1 &#40;0&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Drugs&#44; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Adrenalin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">107 &#40;85&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Atropine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67 &#40;53&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Amiodarone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Patients arriving in hospital&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;48&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Patients with RSC upon hospital admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36 &#40;28&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ongoing resuscitation upon admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25 &#40;20&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab1381914.png"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Pre-hospital treatment measures&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
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        "tabla" => array:3 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">EAP&#58; electrical activity with pulse&#59; EAWP&#58; electrical activity without pulse&#59; CPC&#58; Cerebral Performance Category&#59; ECT&#58; emergency care team&#59; VF&#58; ventricular fibrillation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">CPC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Witnessed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Resuscitation by witness&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Initial rhythm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cause&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Interval arrest-arrival ECT &#40;min&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Survival &#40;months&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Extreme bradycardia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Drowning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;primary care center&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">VF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Electrocution&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">42&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">VF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;ECT&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ECT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EAP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Anaphylactic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Asystolia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Drowning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Asystolia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Drowning&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes &#40;ECT&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">ECT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">EAWP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Traumatic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Asystolia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">The patient received advanced life support measures in the primary care center&#46; Electrical activity with pulse was evidenced upon arrival of the emergency care team&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Characteristics of the survivors at hospital discharge&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:28 [
            0 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A prospective&#44; population-based study of the demographics&#44; epidemiology&#44; management&#44; and outcome of out-of-hospital pediatric cardiopulmonary arrest"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46;E&#46; Sirbaugh"
                            1 => "P&#46;E&#46; Pepe"
                            2 => "J&#46;E&#46; Shook"
                            3 => "K&#46;T&#46; Kimball"
                            4 => "M&#46;J&#46; Goldman"
                            5 => "M&#46;A&#46; Ward"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med"
                        "fecha" => "1999"
                        "volumen" => "33"
                        "paginaInicial" => "174"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9922413"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Out-of-hospital pediatric cardiac arrest&#58; an epidemiologic review and assessment of current knowledge"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;J&#46; Donoghue"
                            1 => "V&#46; Nadkarni"
                            2 => "R&#46;A&#46; Berg"
                            3 => "M&#46;H&#46; Osmond"
                            4 => "G&#46; Wells"
                            5 => "L&#46; Nesbitt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.annemergmed.2005.05.028"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Emerg Med"
                        "fecha" => "2005"
                        "volumen" => "46"
                        "paginaInicial" => "512"
                        "paginaFinal" => "522"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16308066"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and outcomes from out-of-hospital cardiac arrest in children&#58; the Resuscitation Outcomes Consortium Epistry-Cardiac Arrest"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;L&#46; Atkins"
                            1 => "S&#46; Everson-Stewart"
                            2 => "G&#46;K&#46; Sears"
                            3 => "M&#46; Daya"
                            4 => "M&#46;H&#46; Osmond"
                            5 => "C&#46;R&#46; Warden"
                          ]
                        ]
                      ]
                    ]
                  ]
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