Epidemiology and outcome of paediatric out-of-hospital cardiac arrests: A paediatric sub-study of the Pan-Asian resuscitation outcomes study (PAROS)

Tham, Lai Peng; Wah, Win; Phillips, Robert; Shahidah, Nur; Ng, Yih Yng; Shin, Sang Do; Nishiuchi, Tatsuya; Wong, Kwanhathai Darin; Ko, Patrick Chow In; Khunklai, Nalinas; Naroo, Ghulam Yasin; Ong, Marcus Eng Hock

doi:10.1016/j.resuscitation.2018.01.040

Cited by 55 publications

(61 citation statements)

References 26 publications

(51 reference statements)

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“…There were signi cant between-group differences in the rates of intubation and de brillation. Furthermore, signi cantly fewer adrenaline doses were administered in the ROSC than in the no ROSC group (4 [2-6] vs 6 [3][4][5][6][7][8][9][10], p <0.05). Table 4 shows the timeline of resuscitative activity.…”

Section: Resultsmentioning

confidence: 99%

“…Out-of-hospital cardiac arrest (OHCA) is very rare in the paediatric population, with an annual incidence of 2-9 cases per 1,000,000 children (1)(2)(3)(4)(5). There are several guidelines on paediatric cardiac arrest, such as the Pediatric Advanced Life Support issued by the American Heart Association: however, the outcome of OHCA in paediatric patients is very poor, with survival rates ranging from 2% to 22% (1)(2)(3)(4)(5)(6). In a recent literature review of the science of paediatric resuscitation, Topjian et al reported that 5-10% of paediatric OHCA victims survive to hospital discharge, and only 0-12% of those have a good neurological outcome (7).…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Adrenaline Doses With the Outcome of Paediatric Out-of-hospital Cardiac Arrest: Secondary Analysis of the SOS-KANTO 2012 Study

Ishihara

Kondo

Sueyoshi

et al. 2020

Preprint

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Background Out-of-hospital cardiac arrest (OHCA) is very rare in the paediatric population, with an annual incidence of 2-9 cases per 1,000,000 children. The predictive factors for survival included a shorter interval between the time of arrest and hospital arrival, a palpable pulse on presentation in the emergency department (ED), a shorter duration of resuscitation in the ED, and the administration of fewer doses of adrenaline in the ED. This study was conducted to evaluated the interrelationship between the paediatric OHCA outcome and the number of adrenaline doses administered during resuscitation. Methods The SOS-KANTO 2012 study had enrolled all OHCA patients who were transported to the participant hospitals by emergency medical service personnel. After screening the available data, we included paediatric OHCA patients (aged ≤ 18 years) in this study. The primary outcome was the return of spontaneous circulation (ROSC) and the number of adrenaline doses that were administered, and the secondary outcome was the neurological outcome at 1 month after the OHCA in relation to the number of adrenaline doses. Results Two hundred sixty-seven patients were included in the final analyses. During CPR, 62 and 205 paediatric patients did and did not achieve ROSC, respectively. Patients who survived to one month after the OHCA received fewer adrenaline doses than patients who died, although there was no significant intergroup difference (3 [1.75-5.25], vs. 4 [2.5-6], p=0.319). Patients with a good neurological outcome (PCPC 1-2) received fewer doses of adrenaline than those with an unfavourable neurological outcome (PCPC 3-6), but intergroup difference was not significant. Fewer doses of adrenaline were associated with an improved rate of successful ROSC (odds ration = 0.80,95% confidence interval = 0.69-0.92, p<0.01). Conclusion The present study reports associations of the neurological outcomes with adrenaline doses in paediatric patients with OHCA. More than three adrenaline doses were associated with poor neurological outcome, and a favourable outcome occurred infrequently. By using information that was only available up to 1 month after the OHCA, we found that a higher number of adrenaline doses was associated with poor neurological outcome.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Correlation of Adrenaline Doses With the Outcome of Paediatric Out-of-hospital Cardiac Arrest: Secondary Analysis of the SOS-KANTO 2012 Study

Ishihara

Kondo

Sueyoshi

et al. 2020

Preprint

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“…The evidence comparing TI with SGA during pediatric resuscitation comes from 4 observational studies of OHCA 111À113,120 ; 2 of these studies used propensity matching. 111,112 When combined, neither the propensity-matched studies 111,112 nor the unadjusted cohort studies 113,120 found a significant association between the choice of advanced airway and survival with favorable neurological function or survival to hospital discharge.…”

Section: Consensus On Sciencementioning

confidence: 93%

“…111,112 Two other observational studies reported only unadjusted data. 113,120 None of these studies found a significant association between SGA use and survival with favorable neurological function or survival to hospital discharge.…”

Section: Consensus On Sciencementioning

confidence: 99%

2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Soar¹,

Maconochie²,

Wyckoff³

et al. 2019

Resuscitation

128

113

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The International Liaison Committee on Resuscitation has initiated a continuous review of new, peer-reviewed, published cardiopulmonary resuscitation science. This is the third annual summary of the International Liaison Committee on Resuscitation International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. It addresses the most recent published resuscitation evidence reviewed by International Liaison Committee on Resuscitation Task Force science experts. This summary addresses the role of cardiac arrest centers and dispatcher-assisted cardiopulmonary resuscitation, the role of extracorporeal cardiopulmonary resuscitation in adults and children, vasopressors in adults, advanced airway interventions in adults and children, targeted temperature management in children after cardiac arrest, initial oxygen concentration during resuscitation of newborns, and interventions for presyncope by first aid providers. Members from 6 International Liaison Committee on Resuscitation task forces have assessed, discussed, and debated the certainty of the evidence on the basis of the Grading of Recommendations, Assessment, Development, and Evaluation criteria, and their statements include consensus treatment recommendations. Insights into the deliberations of the task forces are provided in the Justification and Evidence to Decision Framework Highlights sections. The task forces also listed priority knowledge gaps for further research.

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“…No bAED use was reported for any POHCA case in the region. Two studies reported ROSC, 5.9% (31) and 14% (29). Two studies reported a survival to discharge rate of approximately 6% (13,31).…”

Section: Process and Outcome Characteristicsmentioning

confidence: 99%

Out-of-hospital cardiac arrest in countries of the Gulf Cooperation Council: a scoping review

Batt¹,

Lanos²,

Delport³

et al. 2021

East Mediterr Health J.

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Background: Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality worldwide. Recent studies demonstrated low survival rates in Middle Eastern countries. Anecdotally there are unique demographic, cultural and logistical challenges in this region. However, there remains a paucity of data published on OHCA in the Middle East. In order to address OHCA in a meaningful manner in the region, we first need to quantify the issue. Methods: We conducted a scoping review of published and grey literature on OHCA in the Gulf Cooperative Council region that utilised Arksey and O’Malley’s framework. Electronic databases and grey literature sources were identified and searched. Subject matter experts in the region were consulted. All types of studies in English and Arabic were included. Results: A total of 24 studies were included from Saudi Arabia, the United Arab Emirates, Oman, Kuwait, and Qatar. No literature was identified from the state of Bahrain. OHCA victims in the region are younger, predominantly male, and more co-morbid than other international studies. We observed low Emergency Medical Service utilisation, low bystander cardiopulmonary resuscitation, return of spontaneous circulation, and survival to discharge rates across the region. There are differences in characteristics of OHCA among ethnic groups. Conclusion: We identified unique characteristics associated with OHCA in the region, variances in processes and outcomes, and a lack of coordinated effort to research and address OHCA. We recommend creating lead agencies responsible for coordinating and developing strategies such as community response, public education, and reporting databases.

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Epidemiology and outcome of paediatric out-of-hospital cardiac arrests: A paediatric sub-study of the Pan-Asian resuscitation outcomes study (PAROS)

Abstract: The wide variation in the survival outcomes amongst the seven countries in our study may be due to the differences in the delivery of pre-hospital interventions and bystander CPR rates.

Cited by 55 publications

References 26 publications

Correlation of Adrenaline Doses With the Outcome of Paediatric Out-of-hospital Cardiac Arrest: Secondary Analysis of the SOS-KANTO 2012 Study

Correlation of Adrenaline Doses With the Outcome of Paediatric Out-of-hospital Cardiac Arrest: Secondary Analysis of the SOS-KANTO 2012 Study

2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations

Out-of-hospital cardiac arrest in countries of the Gulf Cooperation Council: a scoping review

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