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

Sutton, Robert M.; Reeder, Ron; Landis, William; Meert, Kathleen L.; Yates, Andrew R.; Berger, John; Newth, Christopher J. L.; Carcillo, Joseph A.; McQuillen, Patrick S.; Harrison, Rick; Moler, Frank W.; Pollack, Murray M.; Carpenter, Todd; Notterman, Daniel A.; Holubkov, Richard; Dean, J. Michael; Nadkarni, Vinay; Zuppa, Athena F.; Graham, Katherine; Twelves, Carolann; DiLiberto, Mary Ann; Tomanio, Elyse; Kwok, Jeni; Bell, Michael J.; Abraham, Abu; Sapru, Anil; Alkhouli, Mustafa F.; Heidemann, Sabrina M.; Pawluszka, Ann; Hall, Mark W.; Steele, Lisa; Shanley, Thomas P.; Weber, Monica; Dalton, Heidi J.; Bell, Aimee La; Mourani, Peter M.; Malone, Kathryn; Telford, Russell; Locandro, Christopher; Coleman, Whitney; Peterson, Alecia; Thelen, Julie; Doctor, Allan

doi:10.1016/j.resuscitation.2018.07.015

Cited by 54 publications

(46 citation statements)

References 42 publications

(61 reference statements)

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“…Many studies have shown that chest compressions are often poorly performed [4,16]. The present data show that the compressions applied in the first group with no-sensor CPR were too fast; this has previously been associated with poorer survival [17,18]. Use of the feedback sensor improved the compression rate, with further improvement when real-time feedback was activated.…”

Section: Compression Frequencymentioning

confidence: 50%

Real-time feedback improves chest compression quality in out-of-hospital cardiac arrest: A prospective cohort study

et al. 2020

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Background Current guidelines underline the importance of high-quality chest compression during cardiopulmonary resuscitation (CPR), to improve outcomes. Contrary to this many studies show that chest compression is often carried out poorly in clinical practice, and long interruptions in compression are observed. This prospective cohort study aimed to analyse whether chest compression quality changes when a real-time feedback system is used to provide simultaneous audiovisual feedback on chest compression quality. For this purpose, pauses in compression, compression frequency and compression depth were compared. Methods The study included 292 out-of-hospital cardiac arrests in three consecutive study groups: first group, conventional resuscitation (no-sensor CPR); second group, using a feedback sensor to collect compression depth data without real-time feedback (sensor-only CPR); and third group, with real-time feedback on compression quality (sensor-feedback CPR). Pauses and frequency were analysed using compression artefacts on electrocardiography, and compression depth was measured using the feedback sensor. With this data, various parameters were determined in order to be able to compare the chest compression quality between the three consecutive groups. Results The compression fraction increased with sensor-only CPR (group 2) in comparison with nosensor CPR (group 1) (80.1% vs. 87.49%; P < 0.001), but there were no further differences belonging compression fraction after activation of sensor-feedback CPR (group 3) (P = 1.00). Compression frequency declined over the three study groups, reaching the guideline

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Section: Compression Frequencymentioning

confidence: 50%

Real-time feedback improves chest compression quality in out-of-hospital cardiac arrest: A prospective cohort study

et al. 2020

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“…Guimier hypothesized that the high energy needs of cardiac myocytes may preclude return of spontaneous circulation (ROSC) despite early and optimal resuscitation in patients with pathologic PPA2 variants, potentially because of an inability of the mitochondria to meet the energy demands of the cell (Guimier et al 2016). This theory may be especially applicable to our patient as the majority of pediatric patients with in-hospital cardiac arrests do achieve ROSC (Sutton et al 2018).…”

Section: Discussionmentioning

confidence: 99%

Postmortem diagnosis of PPA2-associated sudden cardiac death from dried blood spot in a neonate presenting with vocal cord paralysis

Sanford

Jones

Brigger

et al. 2020

Cold Spring Harb Mol Case Stud

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Biallelic variants in inorganic pyrophosphatase 2 (PPA2) are known to cause infantile sudden cardiac failure (OMIM #617222), but relatively little is known about phenotypic variability of these patients prior to their death. We report a 5-wk-old male with bilateral vocal cord paralysis and hypertension who had a sudden unexpected cardiac death. Subsequently, molecular autopsy via whole-genome sequencing from newborn dried blood spot identified compound heterozygous mutations in PPA2, with a paternally inherited, pathogenic missense variant (c.514G > A; p.Glu172Lys) and a novel, maternally inherited missense variant of uncertain significance (c.442A > T; p.Thr148Ser). This report expands the presenting phenotype of patients with PPA2 variants. It also highlights the utility of dried blood spots for postmortem molecular diagnosis.

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“…If spontaneous circulation is recovered, it is not uncommon for a child to have another CPA shortly afterwards and this second episode may be owing to PEA or an abnormal cardiac rhythm requiring defibrillation [12,13]. In many low-income settings without a cardiac monitor, the rhythm may not be known.…”

Section: Delivery Of Cardiopulmonary Resuscitationmentioning

confidence: 99%

Cardiopulmonary resuscitation in poorly resourced settings: better to pre-empt than to wait until it is too late

Molyneux

2019

Paediatrics and International Child Health

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

Abstract: 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.

Cited by 54 publications

References 42 publications

Real-time feedback improves chest compression quality in out-of-hospital cardiac arrest: A prospective cohort study

Real-time feedback improves chest compression quality in out-of-hospital cardiac arrest: A prospective cohort study

Postmortem diagnosis of PPA2-associated sudden cardiac death from dried blood spot in a neonate presenting with vocal cord paralysis

Cardiopulmonary resuscitation in poorly resourced settings: better to pre-empt than to wait until it is too late

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