Correction to: Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Wilkins, Lippincott Williams

doi:10.1161/cir.0000000000000445

Cited by 54 publications

(77 citation statements)

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“…The most recent American Heart Association CPR and Emergency Cardiovascular Care Guidelines that integrate 2010 (in- and out-of-hospital cardiac arrests) and 2015 (in-hospital cardiac arrests) recommend the following: “ ECPR may be considered for pediatric patients with cardiac diagnoses who have in-hospital cardiac arrest in settings with existing ECMO protocols, expertise, and equipment (Class IIb, LOE C-LD) .” There is however, insufficient published data to support the benefit of ECPR over conventional CPR in all pediatric cardiac arrest events ( 32 – 35 ).…”

Section: Patient Selectionmentioning

confidence: 99%

Establishing and Sustaining an ECPR Program

Laussen

Guerguerian

2018

Front. Pediatr.

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The use of extracorporeal support after failed return of a spontaneous ciruculation during cardiopulmonary resuscitation (ECPR) is well described. There are 4 distinct phases for resuscitation with ECPR and the time spent in each phase is critical for successful outcome. Recommendations for ECPR previously published by the American Heart Association provide the context for implementing a consistent and well-rehearsed system for ECPR, by people with the knowledge, experience and resources to deploy ECPR in the most optimal time frame possible in selected patient populations. In this manuscript we review the current status of ECPR for acute cardiac failure and the components we believe are necessary to develop and sustain a reliable and resilient program.

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Section: Patient Selectionmentioning

confidence: 99%

Establishing and Sustaining an ECPR Program

Laussen

Guerguerian

2018

Front. Pediatr.

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“…Existing treatments for out-of-hospital cardiac arrest combine cardiopulmonary resuscitation (CPR) and early defibrillation by bystanders or first responders with advanced cardiac life support by emergency medical services (EMS) personnel. The advanced life support treatments include CPR, defibrillation, intravenous drugs, and postresuscitation care . Neurological injury is the major cause of morbidity and mortality in these patients; most resuscitated patients never regain consciousness .…”

Section: Introductionmentioning

confidence: 99%

“…The advanced life support treatments include CPR, defibrillation, intravenous drugs, and postresuscitation care. [2][3][4] Neurological injury is the major cause of morbidity and mortality in these patients; most resuscitated patients never regain consciousness. [5][6][7][8] Despite advances in resuscitation, more than 80% of those in whom circulation was restored after out-of-hospital cardiac arrest died before hospital discharge in studies with data collected between 2005 and 2015.…”

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confidence: 99%

Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest

Kim

Maynard

Dezfulian

et al. 2021

JAMA

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IMPORTANCE Therapeutic delivery of sodium nitrite during resuscitation improved survival in animal models of cardiac arrest, but efficacy has not been evaluated in clinical trials in humans.OBJECTIVE To determine whether parenteral administration of sodium nitrite given by paramedics during resuscitation for out-of-hospital cardiac arrest improved survival to hospital admission. DESIGN, SETTING, AND PARTICIPANTS Double-blind, placebo-controlled, phase 2 randomized clinical trial including 1502 adults in King County, Washington, with out-of-hospital cardiac arrest from ventricular fibrillation or nonventricular fibrillation. Patients underwent resuscitation by paramedics and were enrolled between February 8, 2018, and August 19, 2019; follow-up and data abstraction were completed by December 31, 2019.INTERVENTIONS Eligible patients with out-of-hospital cardiac arrest were randomized (1:1:1) to receive 45 mg of sodium nitrite (n = 500), 60 mg of sodium nitrite (n = 498), or placebo (n = 499), which was given via bolus injection by the paramedics as soon as possible during active resuscitation. MAIN OUTCOMES AND MEASURESThe primary outcome was survival to hospital admission and was evaluated with 1-sided hypothesis testing. The secondary outcomes included out-of-hospital variables (rate of return of spontaneous circulation, rate of rearrest, and use of norepinephrine to support blood pressure) and in-hospital variables (survival to hospital discharge; neurological outcomes at hospital discharge; cumulative survival to 24 hours, 48 hours, and 72 hours; and number of days in the intensive care unit). RESULTS Among 1502 patients with out-of-hospital cardiac arrest who were randomized (mean age, 64 years [SD, 17 years]; 34% were women), 99% completed the trial. Overall, 205 patients (41%) in the 45 mg of sodium nitrite group and 212 patients (43%) in the 60 mg of sodium nitrite group compared with 218 patients (44%) in the placebo group survived to hospital admission; the mean difference for the 45-mg dose vs placebo was −2.9% (1-sided 95% CI, −8.0% to ϱ; P = .82) and the mean difference for the 60-mg dose vs placebo was −1.3% (1-sided 95% CI, −6.5% to ϱ; P = .66). None of the 7 prespecified secondary outcomes were significantly different, including survival to hospital discharge for 66 patients (13.2%) in the 45 mg of sodium nitrite group and 72 patients (14.5%) in the 60 mg of sodium nitrite group compared with 74 patients (14.9%) in the placebo group; the mean difference for the 45-mg dose vs placebo was −1.7% (2-sided 95% CI, −6.0% to 2.6%; P = .44) and the mean difference for the 60-mg dose vs placebo was −0.4% (2-sided 95% CI, −4.9% to 4.0%; P = .85).CONCLUSIONS AND RELEVANCE Among patients with out-of-hospital cardiac arrest, administration of sodium nitrite, compared with placebo, did not significantly improve survival to hospital admission. These findings do not support the use of sodium nitrite during resuscitation from out-of-hospital cardiac arrest.

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“…The authors have focused on an important area of postresuscitation care, because hyperoxia (defined as Pa o 2 >300 mm Hg) has shown to be associated with worse outcomes . In contrast to a 2022 study, the study by Dr Bernard and colleagues did not report any benefit for low oxygen targets, although the oxygen target for the intervention group (peripheral oxygen saturation of 90%-94%) was far below international recommendations . Thus, this trial compared hypoxia with normoxia rather than normoxia with hyperoxia and, not surprisingly, the intervention group experienced more episodes of hypoxemia and rearrest.…”

mentioning

confidence: 59%