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Critical Care Medicine • Volume 46 • Number 1 (Supplement) www.ccmjournal.org Learning Objectives: Animal studies established that interruptions in chest compressions (pauses) have deleterious hemodynamic effects. The objective of this study was to evaluate the effect of pauses on invasively measured blood pressures during actual pediatric In-Hospital Cardiac Arrest (p-IHCA). We hypothesized that invasively measured blood pressures would be higher pre vs. post chest compression pauses. Methods: This was a prospective, single-center, observational study of pediatric (≤18 years) intensive care unit CA events. All subjects had an invasive arterial line in place at the time of arrest. A pause was defined as an interruption in chest compressions of ≥1s. Systolic and Diastolic Blood Pressures (SBP, DBP) were determined for individual compressions. For the primary analysis, the average SBP and DBP of the last three compressions preceding each pause were compared to the first 3 compressions following each pause using a paired t-test. Secondary analyses were conducted for pauses of ≥2s, ≥3s, and ≥6s. Results: Between 9/2013 and 4/2016, there were 20 events with complete data among 18 subjects, yielding 79 evaluable pauses. The median age at arrest was 3 yrs (IQR 1 – 15yrs). Return of circulation was achieved in 15 (75%) events. The median pause length was 3.5s (IQR 1.5 – 7.6s). SBP and DBP were not significantly different pre vs. post pause: SBP 93.5 ± 4.6 vs. 93.3 ± 4.4mmHg, p = 0.96; DBP 31.6 ± 1.6 vs. 31.9 ± 1.8mmHg, p = 0.72. Subgroup analyses considering rhythm (shockable vs. non-shockable), pause number, and time from start of event to pause (s) had similar results. Secondary analyses showed no significant difference for pauses of ≥2s, ≥3s, and ≥6s (p> 0.05). Conclusions: In this single center study at a hospital that focuses on titrating chest compressions to invasive blood pressure targets, chest compression pauses of up to 6 seconds did not result in statistically significant lower systolic or diastolic blood pressures.