Abstract
Aim: The primary aim of this study was to evaluate the association between chest compression rates and 1) arterial blood pressure and 2) survival outcomes during pediatric in-hospital cardiopulmonary resuscitation (CPR). Methods: Prospective observational study of children ≥37 weeks gestation and <19 years old who received CPR in an intensive care unit (ICU) as part of the Pediatric Intensive Care Unit Quality of CPR Study (PICqCPR) of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Arterial blood pressure and compression rate were determined from manually extracted arterial line waveform data during the first 10 min of CPR. The primary outcome was survival to hospital discharge. Modified Poisson regression models assessed the association between rate categories (80–<100, 100–120 [Guidelines], >120–140, >140) and outcomes. Results: Compression rate data were available for 164 patients. More than half (98/164; 60%) were <1 year old. Return of circulation was achieved in 148/164 (90%); survival to hospital discharge in 77/164 (47%). Percentage of events with average rate within Guidelines was 32.9%. Compared to Guidelines, higher rate categories were associated with lower systolic blood pressures (>120–140, p = 0.010; >140, p = 0.077), but not survival. A rate between 80-<100 per minute was associated with a higher rate of survival to hospital discharge (aRR 1.92, CI95 1.13, 3.29, p = 0.017) and survival with favorable neurological outcome (aRR 2.12, CI95 1.09, 4.13, p = 0.027) compared to Guidelines. Conclusion: Non-compliance with compression rate Guidelines was common in this multicenter cohort. Among ICU patients, slightly lower rates were associated with improved outcomes compared to Guidelines.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 159-166 |
| Number of pages | 8 |
| Journal | Resuscitation |
| Volume | 130 |
| DOIs | |
| State | Published - Sep 1 2018 |
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Keywords
- Cardiac arrest
- Cardiopulmonary resuscitation
- Intensive care unit
- Pediatric
ASJC Scopus subject areas
- Emergency Medicine
- Emergency
- Cardiology and Cardiovascular Medicine
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Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes. / the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators.
In: Resuscitation, Vol. 130, 01.09.2018, p. 159-166.Research output: Contribution to journal › Article
TY - JOUR
T1 - Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes
AU - the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators
AU - Sutton, Robert M.
AU - Reeder, Ron W.
AU - Landis, William
AU - Meert, Kathleen L.
AU - Yates, Andrew R.
AU - Berger, John T.
AU - Newth, Christopher J.
AU - Carcillo, Joseph A.
AU - McQuillen, Patrick S.
AU - Harrison, Rick E.
AU - Moler, Frank W.
AU - Pollack, Murray M.
AU - Carpenter, Todd C.
AU - Notterman, Daniel A.
AU - Holubkov, Richard
AU - Dean, J. Michael
AU - Nadkarni, Vinay M.
AU - Berg, Robert A.
AU - Zuppa, Athena F.
AU - Graham, Katherine
AU - Twelves, Carolann
AU - Diliberto, Mary Ann
AU - Tomanio, Elyse
AU - Kwok, Jeni
AU - Bell, Michael J.
AU - Abraham, Alan
AU - Sapru, Anil
AU - Alkhouli, Mustafa F.
AU - Heidemann, Sabrina
AU - Pawluszka, Ann
AU - Hall, Mark W.
AU - Steele, Lisa
AU - Shanley, Thomas Patrick
AU - Weber, Monica
AU - Dalton, Heidi J.
AU - Bell, Aimee La
AU - Mourani, Peter M.
AU - Malone, Kathryn
AU - Telford, Russell
AU - Locandro, Christopher
AU - Coleman, Whitney
AU - Peterson, Alecia
AU - Thelen, Julie
AU - Doctor, Allan
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Aim: The primary aim of this study was to evaluate the association between chest compression rates and 1) arterial blood pressure and 2) survival outcomes during pediatric in-hospital cardiopulmonary resuscitation (CPR). Methods: Prospective observational study of children ≥37 weeks gestation and <19 years old who received CPR in an intensive care unit (ICU) as part of the Pediatric Intensive Care Unit Quality of CPR Study (PICqCPR) of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Arterial blood pressure and compression rate were determined from manually extracted arterial line waveform data during the first 10 min of CPR. The primary outcome was survival to hospital discharge. Modified Poisson regression models assessed the association between rate categories (80–<100, 100–120 [Guidelines], >120–140, >140) and outcomes. Results: Compression rate data were available for 164 patients. More than half (98/164; 60%) were <1 year old. Return of circulation was achieved in 148/164 (90%); survival to hospital discharge in 77/164 (47%). Percentage of events with average rate within Guidelines was 32.9%. Compared to Guidelines, higher rate categories were associated with lower systolic blood pressures (>120–140, p = 0.010; >140, p = 0.077), but not survival. A rate between 80-<100 per minute was associated with a higher rate of survival to hospital discharge (aRR 1.92, CI95 1.13, 3.29, p = 0.017) and survival with favorable neurological outcome (aRR 2.12, CI95 1.09, 4.13, p = 0.027) compared to Guidelines. Conclusion: Non-compliance with compression rate Guidelines was common in this multicenter cohort. Among ICU patients, slightly lower rates were associated with improved outcomes compared to Guidelines.
AB - Aim: The primary aim of this study was to evaluate the association between chest compression rates and 1) arterial blood pressure and 2) survival outcomes during pediatric in-hospital cardiopulmonary resuscitation (CPR). Methods: Prospective observational study of children ≥37 weeks gestation and <19 years old who received CPR in an intensive care unit (ICU) as part of the Pediatric Intensive Care Unit Quality of CPR Study (PICqCPR) of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Arterial blood pressure and compression rate were determined from manually extracted arterial line waveform data during the first 10 min of CPR. The primary outcome was survival to hospital discharge. Modified Poisson regression models assessed the association between rate categories (80–<100, 100–120 [Guidelines], >120–140, >140) and outcomes. Results: Compression rate data were available for 164 patients. More than half (98/164; 60%) were <1 year old. Return of circulation was achieved in 148/164 (90%); survival to hospital discharge in 77/164 (47%). Percentage of events with average rate within Guidelines was 32.9%. Compared to Guidelines, higher rate categories were associated with lower systolic blood pressures (>120–140, p = 0.010; >140, p = 0.077), but not survival. A rate between 80-<100 per minute was associated with a higher rate of survival to hospital discharge (aRR 1.92, CI95 1.13, 3.29, p = 0.017) and survival with favorable neurological outcome (aRR 2.12, CI95 1.09, 4.13, p = 0.027) compared to Guidelines. Conclusion: Non-compliance with compression rate Guidelines was common in this multicenter cohort. Among ICU patients, slightly lower rates were associated with improved outcomes compared to Guidelines.
KW - Cardiac arrest
KW - Cardiopulmonary resuscitation
KW - Intensive care unit
KW - Pediatric
UR - http://www.scopus.com/inward/record.url?scp=85050463104&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85050463104&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2018.07.015
DO - 10.1016/j.resuscitation.2018.07.015
M3 - Article
C2 - 30031055
AN - SCOPUS:85050463104
VL - 130
SP - 159
EP - 166
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
ER -