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

Research output: Contribution to journalArticle

8 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)159-166
Number of pages8
JournalResuscitation
Volume130
DOIs
StatePublished - Sep 1 2018

Fingerprint

Pediatric Hospitals
Heart Arrest
Thorax
Guidelines
Survival
Data Compression
Cardiopulmonary Resuscitation
Observational Studies
Arterial Pressure
Survival Rate
Prospective Studies
Pregnancy

Keywords

  • Cardiac arrest
  • Cardiopulmonary resuscitation
  • Intensive care unit
  • Pediatric

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators (2018). Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes. Resuscitation, 130, 159-166. https://doi.org/10.1016/j.resuscitation.2018.07.015
the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators. / Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes. In: Resuscitation. 2018 ; Vol. 130. pp. 159-166.
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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.",
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the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators 2018, 'Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes', Resuscitation, vol. 130, pp. 159-166. https://doi.org/10.1016/j.resuscitation.2018.07.015

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 journalArticle

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

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the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators. Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes. Resuscitation. 2018 Sep 1;130:159-166. https://doi.org/10.1016/j.resuscitation.2018.07.015