The Frequency of Cardiac Arrests in Patients with Congenital Heart Disease Undergoing Cardiac Catheterization

Odegard, Kirsten C.; Bergersen, Lisa; Thiagarajan, Ravi R.; Clark, Laura; Shukla, Avinash; Wypij, David; Laussen, Peter C.

doi:10.1213/ane.0b013e3182908bcb

Cited by 92 publications

(49 citation statements)

References 19 publications

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“…For the critical outcome of survival to hospital discharge, we identified very-low-quality evidence from 4 pediatric observational studies of IHCA [71][72][73][74] (downgraded for indirectness, inconsistency, and residual confounding) and very-low-quality evidence from 1 unpublished analysis of a study's public dataset 75 (downgraded for serious risk of residual confounding) showing no benefit to the use of ECPR when compared with CPR without the use of ECMO (RR range, 0.64-1.63). We also identified low-quality evidence (downgraded for indirectness, inconsistency, and residual confounding) from a single pediatric study of IHCA 76 that showed benefit to ECPR when compared with CPR without the use of ECMO (OR, 2.5; 95% CI, 1.3-4.5; P=0.007 in surgical cardiac diagnoses; OR, 3.8; 95% CI, 1.4-5.8; P=0.011 in medical cardiac diagnoses).…”

Section: Consensus On Sciencementioning

confidence: 99%

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Caen¹,

Maconochie²,

Aickin³

et al. 2015

Circulation

152

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The Pediatric Task Force reviewed all questions submitted by the International Liaison Committee on Resuscitation (ILCOR) member councils in 2010, reviewed all council training materials and resuscitation guidelines and algorithms, and conferred on recent areas of interest and controversy. We identified a few areas where there were key differences in council-specific guidelines based on historical recommendations, such as the A-B-C (Airway, Breathing, Circulation) versus C-A-B (Circulation, Airway, Breathing) sequence of provision of cardiopulmonary resuscitation (CPR), initial back blows versus abdominal thrusts for foreign-body airway obstruction, an upper limit for recommended chest compression rate, and initial defibrillation dose for shockable rhythms (2 versus 4 J/kg). We produced a working list of prioritized questions and topics, which was adjusted with the advent of new research evidence. This led to a prioritized palate of 21 PICO (population, intervention, comparator, outcome) questions for ILCOR task force focus.The 2015 process was supported by information specialists who performed in-depth systematic searches, liaising with pediatric content experts so that the most appropriate terms and outcomes and the most relevant publications were identified. Relevant adult literature was considered (extrapolated) in those PICO questions that overlapped with other task forces, or when there were insufficient pediatric data. In rare circumstances (in the absence of sufficient human data), appropriate animal studies were incorporated into reviews of the literature. However, these data were considered only when higher levels of evidence were not available and the topic was deemed critical.When formulating the PICO questions, the task force felt it important to evaluate patient outcomes that extend beyond return of spontaneous circulation (ROSC) or discharge from the pediatric intensive care unit (PICU). In recognition that the measures must have meaning, not only to clinicians but also to parents and caregivers, longer-term outcomes at 30 days, 60 days, 180 days, and 1 year with favorable neurologic status were included in the relevant PICO questions.Each task force performed a detailed systematic review based on the recommendations of the Institute of Medicine of the National Academies 1 and using the methodological approach proposed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) working group.2 After identifying and prioritizing the questions to be addressed (by using the PICO format) 3 with the assistance of information specialists, a detailed search for relevant articles was performed in each of 3 online databases (PubMed, Embase, and the Cochrane Library).By using detailed inclusion and exclusion criteria, articles were screened for further evaluation. The reviewers for each question created a reconciled risk-of-bias assessment for each of the included studies, using state-of-the-art tools: Cochrane for randomized controlled trials (RCTs), 4 Quality Assessment of Diagnosti...

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Section: Consensus On Sciencementioning

confidence: 99%

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Caen¹,

Maconochie²,

Aickin³

et al. 2015

Circulation

152

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“…(70)(71)(72)(73) ECMO, however, was associated with increased complications (e.g. haemorrhage, thrombotic events) and was more resource-intensive.…”

Section: Ecmo In Cpr and Paediatric Ihcamentioning

confidence: 99%

Singapore Paediatric Resuscitation Guidelines 2016

Ong

Chan

et al. 2017

smedj

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“…Cardiac arrest is more likely to occur in high-risk children with no correlation to an increase in mortality [15]. A similar more recent analysis of the incidence of perioperative cardiac arrest in children undergoing cardiac catheterization highlighted the need for anticipation of a cardiac arrest and correct team communication to prevent adverse outcomes [16].…”

Section: Definition Risk Factors and Epidemiologymentioning

confidence: 99%

Cardiac Arrest in Children

Lampugnani

Lerman

Grasso

et al. 2017

Curr Anesthesiol Rep

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Perioperative cardiac arrest in children is a rare but catastrophic adverse event. It is difficult to investigate the incidence, risk factors, causes, and outcomes from these events, but the exercise is extremely useful in order to develop strategies to prevent it. Recent data identified several major risk factors for cardiac arrest in children: American Society of Anesthesiologists (ASA) physical status >3, age <1 year, and lack of specific pediatric experience by the healthcare providers. Since 1994, when the Perioperative Cardiac Arrest (POCA) Registry was created, the frequency of medicationrelated causes of cardiac arrest in children has decreased while the frequency of respiratory and cardiovascular causes has increased. The International Liaison Committee on Resuscitation Consensus Conference adopted the "5H+5T" acronym for the reversible causes of pediatric cardiac arrest: hypoxia, hypovolemia, hyper/hypokalemia, hypothermia, tension pneumothorax, cardiac tamponade, toxins, and cardiopulmonary thromboembolism. In this review article, the pathophysiology, diagnostic pathway, and treatment of perioperative cardiac arrest in children will be addressed. The importance of a certified training of anesthesiologists in pediatric advanced life support is also highlighted.

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The Frequency of Cardiac Arrests in Patients with Congenital Heart Disease Undergoing Cardiac Catheterization

Cited by 92 publications

References 19 publications

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support

Singapore Paediatric Resuscitation Guidelines 2016

Cardiac Arrest in Children

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