First quantitative analysis of cardiopulmonary resuscitation quality during in-hospital cardiac arrests of young children

Aim: The objective of this study is to report, for the first time, quantitative data on CPR quality during the resuscitation of children under 8 years of age. We hypothesized that the CPR performed would often not achieve 2010 Pediatric Basic Life Support (BLS) Guidelines, but would improve with the addition of audiovisual feedback. Methods: Prospective observational cohort evaluating CPR quality during chest compression (CC) events in children between 1 and 8 years of age. CPR recording defibrillators collected CPR data (rate (CC/min), depth (mm), CC fraction (CCF), leaning (%> 2.5 kg.)). Audiovisual feedback was according to 2010 Guidelines in a subset of patients. The primary outcome, "excellent CPR" was defined as a CC rate >= 100 and <= 120 CC/min, depth >= 50 mm, CCF >0.80, and <20% of CC with leaning. Results: 8 CC events resulted in 285 thirty-second epochs of CPR (15,960 CCs). Percentage of epochs achieving targets was 54% (1531285) for rate, 19% (541285) for depth, 88% (2501285) for CCF, 79% (2261285) for leaning, and 8% (241285) for excellent CPR. The median percentage of epochs per event achieving targets increased with audiovisual feedback for rate [88 (IQR: 79, 94) vs. 39 (IQR 18, 62) %; p = 0.043] and excellent CPR [28 (IQR: 7.2, 52) vs. 0 (IQR: 0,1) %; p = 0.018]. Conclusions: In-hospital pediatric CPR often does not meet 2010 Pediatric BLS Guidelines, but compliance is better when audiovisual feedback is provided to rescuers. (C) 2013 Elsevier Ireland Ltd. All rights reserved.