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This could be due to the fact that creatinine may not be an adequate indicator of kidney function in critically ill children, as increased creatinine levels may occur late or be lower as a result of the malnutrition often occurring in these patients. Furthermore, patients who develop acute kidney failure are treated early with extrarenal www.selleck.co.jp/products/Adrucil(Fluorouracil).html purification techniques and may have normal levels of creatinine at the time of CA, as happened in two of our cases. On the other hand, normal creatinine levels vary as a function of age. Therefore, creatinine levels prior to CA should be replaced by classification of kidney function using the AKIN or RIFLE criteria.23 In children who have received CPR for CA, a urine output greater than 1?mL/kg/h indicates a favourable prognosis.24 In adults, creatinine levels after CA are prognostic indicators, and improved creatinine values in the first 24?h post-arrest (an hourly decrease of 0.2?mg/dL in creatinine levels) are a favourable prognostic indicator.25 Various authors have found that patients who were receiving vasoactive treatment at the time of CA have higher mortality.26, 27?and?28 In a study with adults, Tian et al. 29 found a significant difference in survival between patients who were receiving vasoactive drugs at the time of CPR and those who were not. On the other hand, patients who were given 2 or more vasoactive drugs had a lower survival Oxalosuccinic acid rate than those who were given only one (6.4% vs. 11.5%, p?check details the degree of haemodynamic support in children after heart surgery, and have found that higher inotropic scores are associated with higher mortality.16, 30, 31?and?32 However, inotropic scores have not been used before to assess CA prognosis in children. Contrary to what we expected, our study did not find significant differences in survival between patients who received inotropic therapy prior to CA and patients who did not. We also did not find differences in relation to adrenaline or to the number and dosages of inotropic drugs received, which we analysed using the inotropic index. One of the possible reasons why the results of our study diverge from the rest may have to do with the characteristics of the studied sample. A considerable percentage of the participants included in our study (45.4%) were in postoperative care, for which they received inotropic drugs. This may be partly why inotropic therapy in these patients does not help to differentiate between them when it comes to prognosis. Our results, consistent with those of Parra et al. 7 for children admitted to a paediatric cardiology ICU and those of Ortmann et al. in children with heart disease,9 support this hypothesis.