Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes.

TitleChest compression rates and pediatric in-hospital cardiac arrest survival outcomes.
Publication TypeJournal Article
Year of Publication2018
AuthorsSutton, RM, Reeder, RW, Landis, W, Meert, KL, Yates, AR, Berger, JT, Newth, CJ, Carcillo, JA, McQuillen, PS, Harrison, RE, Moler, FW, Pollack, MM, Carpenter, TC, Notterman, DA, Holubkov, R, J Dean, M, Nadkarni, VM, Berg, RA
Corporate Authors
JournalResuscitation
Volume130
Pagination159-166
Date Published2018 09
ISSN1873-1570
KeywordsAdolescent, Blood Pressure Determination, Child, Child, Preschool, Guideline Adherence, Heart Arrest, Heart Massage, Hospital Mortality, Hospitals, Pediatric, Humans, Infant, Intensive Care Units, Pediatric, Male, Nervous System Diseases, Outcome and Process Assessment, Health Care, Practice Guidelines as Topic, Pressure, Quality Improvement, United States
Abstract

<p><b>AIM: </b>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).</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSION: </b>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.</p>

DOI10.1016/j.resuscitation.2018.07.015
Alternate JournalResuscitation
PubMed ID30031055
PubMed Central IDPMC6170369
Grant ListU10 HD063108 / HD / NICHD NIH HHS / United States
UG1 HD050012 / HD / NICHD NIH HHS / United States
UG1 HD049983 / HD / NICHD NIH HHS / United States
UG1 HD050096 / HD / NICHD NIH HHS / United States
UG1 HD083170 / HD / NICHD NIH HHS / United States
UG1 HD083166 / HD / NICHD NIH HHS / United States
U10 HD063106 / HD / NICHD NIH HHS / United States
U01 HD049934 / HD / NICHD NIH HHS / United States
UG1 HD049981 / HD / NICHD NIH HHS / United States