Survival With Favorable Neurologic Outcome and Quality of Cardiopulmonary Resuscitation Following In-Hospital Cardiac Arrest in Children With Cardiac Disease Compared With Noncardiac Disease

被引：7

作者：

Federman, Myke ^{[1
]}

Sutton, Robert M. ^{[2
]}

Reeder, Ron W. ^{[3
]}

Ahmed, Tageldin ^{[4
]}

Bell, Michael J. ^{[5
]}

Berg, Robert A. ^{[2
]}

Bishop, Robert ^{[6
,7
]}

Bochkoris, Matthew ^{[8
]}

Burns, Candice ^{[9
]}

Carcillo, Joseph A. ^{[8
]}

Carpenter, Todd C. ^{[6
,7
]}

Dean, J. Michael ^{[3
]}

Diddle, J. Wesley ^{[5
]}

Fernandez, Richard ^{[10
]}

Fink, Ericka L. ^{[8
]}

Franzon, Deborah ^{[11
]}

Frazier, Aisha H. ^{[12
,13
]}

Friess, Stuart H. ^{[14
]}

Graham, Kathryn ^{[2
]}

Hall, Mark ^{[10
]}

Hehir, David A. ^{[2
]}

Horvat, Christopher M. ^{[8
]}

Huard, Leanna L. ^{[1
]}

Kirkpatrick, Theresa ^{[1
]}

Maa, Tensing ^{[10
]}

Maitoza, Laura A. ^{[1
]}

Manga, Arushi ^{[14
]}

Mcquillen, Patrick S. ^{[11
]}

Meert, Kathleen L. ^{[4
]}

Morgan, Ryan W. ^{[2
]}

Mourani, Peter M. ^{[14
]}

Nadkarni, Vinay M. ^{[2
]}

Notterman, Daniel ^{[15
]}

Palmer, Chella A. ^{[3
]}

Pollack, Murray M. ^{[5
]}

Sapru, Anil ^{[1
]}

Schneiter, Carleen ^{[6
,7
]}

Sharron, Matthew P. ^{[5
]}

Srivastava, Neeraj ^{[1
]}

Tilford, Bradley ^{[4
]}

Viteri, Shirley ^{[16
,17
]}

Wessel, David ^{[5
]}

Wolfe, Heather A. ^{[2
]}

Yates, Andrew R. ^{[10
]}

Zuppa, Athena F. ^{[2
]}

Naim, Maryam Y. ^{[2
]}

机构：

[1] Univ Calif Los Angeles, Mattel Childrens Hosp, Dept Pediat, Los Angeles, CA 90095 USA

[2] Univ Penn, Childrens Hosp Philadelphia, Dept Anesthesiol & Crit Care Med, Philadelphia, PA USA

[3] Univ Utah, Dept Pediat, Salt Lake City, UT USA

[4] Cent Michigan Univ, Childrens Hosp Michigan, Dept Pediat, Detroit, MI USA

[5] George Washington Univ, Childrens Natl Hosp, Sch Med, Dept Pediat, Washington, DC USA

[6] Univ Colorado, Sch Med, Dept Pediat, Aurora, CO USA

[7] Childrens Hosp Colorado, Dept Pediat, Aurora, CO USA

[8] Univ Pittsburgh, UPMC Childrens Hosp Pittsburgh, Dept Crit Care Med, Pittsburgh, PA USA

[9] Michigan State Univ, Dept Pediat & Human Dev, Grand Rapids, MI USA

[10] Ohio State Univ, Nationwide Childrens Hosp, Dept Pediat, Columbus, OH USA

[11] Univ Calif San Francisco, Dept Pediat, Benioff Childrenss, San Francisco, CA USA

[12] Nemours Childrens Hosp, Nemours Cardiac Ctr, Wilmington, DE USA

[13] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Dept Pediat, Philadelphia, PA USA

[14] Washington Univ, Sch Med, Dept Pediat, St Louis, MO USA

[15] Princeton Univ, Dept Mol Biol, Princeton, NJ USA

[16] Nemours Childrens Hosp, Dept Pediat, Delaware, DE USA

[17] Thomas Jefferson Univ, Wilmington, DE USA

来源：

PEDIATRIC CRITICAL CARE MEDICINE | 2024年 / 25卷 / 01期

关键词：

cardiopulmonary resuscitation; child; congenital heart disease; infant; in-hospital cardiac arrest; DIOXIDE TENSION DIFFERENCE; HEART; ARTERIAL; ASSOCIATION; SINGLE;

D O I：

10.1097/PCC.0000000000003368

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

OBJECTIVES: To assess associations between outcome and cardiopulmonary resuscitation (CPR) quality for in-hospital cardiac arrest (IHCA) in children with medical cardiac, surgical cardiac, or noncardiac disease.DESIGN: Secondary analysis of a multicenter cluster randomized trial, the ICU-RESUScitation Project (NCT02837497, 2016-2021).SETTING: Eighteen PICUs.PATIENTS: Children less than or equal to 18 years old and greater than or equal to 37 weeks postconceptual age receiving chest compressions (CC) of any duration during the study.INTERVENTIONS: NoneMEASUREMENTS AND MAIN RESULTS: Of 1,100 children with IHCA, there were 273 medical cardiac (25%), 383 surgical cardiac (35%), and 444 noncardiac (40%) cases. Favorable neurologic outcome was defined as no more than moderate disability or no worsening from baseline Pediatric Cerebral Performance Category at discharge. The medical cardiac group had lower odds of survival with favorable neurologic outcomes compared with the noncardiac group (48% vs 55%; adjusted odds ratio [aOR] [95% CI], aOR 0.59 [95% CI, 0.39-0.87], p = 0.008) and surgical cardiac group (48% vs 58%; aOR 0.64 [95% CI, 0.45-0.9], p = 0.01). We failed to identify a difference in favorable outcomes between surgical cardiac and noncardiac groups. We also failed to identify differences in CC rate, CC fraction, ventilation rate, intra-arrest average target diastolic or systolic blood pressure between medical cardiac versus noncardiac, and surgical cardiac versus noncardiac groups. The surgical cardiac group had lower odds of achieving target CC depth compared to the noncardiac group (OR 0.15 [95% CI, 0.02-0.52], p = 0.001). We failed to identify a difference in the percentage of patients achieving target CC depth when comparing medical cardiac versus noncardiac groups.CONCLUSIONS: In pediatric IHCA, medical cardiac patients had lower odds of survival with favorable neurologic outcomes compared with noncardiac and surgical cardiac patients. We failed to find differences in CPR quality between medical cardiac and noncardiac patients, but there were lower odds of achieving target CC depth in surgical cardiac compared to noncardiac patients.

引用

页码：4 / 14

页数：11

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