Location of arrest and survival from out-of-hospital cardiac arrest among children in the public-access defibrillation era in Japan

Matsui, Satoshi; Kitamura, Tetsuhisa; Sado, Junya; Kiyohara, Kosuke; Kobayashi, Daisuke; Nishiyama, Chika; Okabayashi, Satoe; Shimamoto, Tomonari; Matsuyama, Tasuku; Kawamura, Takashi; Iwami, Taku; Tanaka, Ryojiro; Kurosawa, Hiroshi; Nitta, Masahiko; Sobue, Tomotaka

doi:10.1016/j.resuscitation.2019.04.045

Cited by 25 publications

(18 citation statements)

References 29 publications

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“…Pediatric OHCA due to external causes accounted for 46.4% in this registry. This prevalence was higher compared with that in previous reports: 30.5% in Japan, 6) 17.2% in the United States, 23) and 34.2% in Australia. 24) Additionally, only two children received shocks delivered through a public-access AED.…”

Section: Discussioncontrasting

confidence: 73%

“…Statistical analysis: Data are presented as the mean ± standard deviation for continuous values and percentages for categorical values. The χ 2 test or Fisher's exact test and one-way analysis of variance were used to analyze statistical differences in in-hospital advanced treatments, drug administrations, and arterial blood gases according to 4 age groups (0 years, 1-4 years, 5-12 years, and 13-17 years based on previous studies 6) ). Additionally, we analyzed trends in outcomes by year and age group.…”

Section: Methodsmentioning

confidence: 99%

“…O ut-of-hospital cardiac arrest (OHCA) is one of the most significant problems in industrialized countries, [1][2][3][4] and pediatric patients who have an OHCA accounted for only a small percentage of the total patient population annually. 5,6) OHCA in children is rare compared with that in adults, but it has a significantly negative impact on the community in terms of life-years lost and healthcare costs in survivors and emotional burden of family members. 7) Therefore, assessing the characteristics, management, and survival of pediatric patients with OHCA is of help in the prevention of OHCA and improvement of survival after OHCA in children.…”

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confidence: 99%

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Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

et al. 2020

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The effect of post-cardiac arrest care in children with out-of-hospital cardiac arrest (OHCA) has not been adequately established, and the long-term outcome after pediatric OHCA has not been sufficiently investigated. We describe here detailed in-hospital characteristics, actual management, and survival, including neurological status, 90 days after OHCA occurrence in children with OHCA transported to critical care medical centers (CCMCs). We analyzed the database of the Comprehensive Registry of Intensive Care for OHCA Survival (CRITI-CAL) study, which is a multicenter, prospective observational data registry designed to accumulate both preand in-hospital data on OHCA treatments. We enrolled all consecutive pediatric patients aged <18 years who had an OHCA and for whom resuscitation was attempted and who were transported to CCMCs between 2012 and 2016. A total of 263 pediatric patients with OHCA were enrolled. The average age of the patients was 6.3 years, 38.0% were aged < 1 year, and 60.8% were male. After hospital arrival, 4.9% of these pediatric patients received defibrillation; 1.9%, extracorporeal life support; 6.5%, target temperature management; and 88.2% adrenaline administration. The proportions of patients with 90-day survival and a pediatric cerebral performance category (PCPC) score of 1 or 2 were 6.1% and 1.9%, respectively. The proportion of patients with a PCPC score of 1 or 2 at 90 days after OHCA occurrence did not significantly improve during the study period. The proportion of pediatric patients with a 90-day PCPC score of 1 or 2 transported to CCMCs was extremely low, and no significant improvements were observed during the study period.

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Section: Discussioncontrasting

confidence: 73%

Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

et al. 2020

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“…Shockable rhythms are less common in infants and children with OHCA (less than 10% 62 , 63 ) compared with in-hospital cardiac arrest (IHCA) (5% to 24% 64 , 65 ) and lower in pediatric than in adult OHCA, 66 as in IHCA cases. 64 The task force acknowledged that the lower frequency of occurrence does affect the sample size for studies to demonstrate statistically significant improvement in survival associated with different defibrillation energy doses.…”

Section: Pals: Manual Defibrillationmentioning

confidence: 99%

Pediatric Life Support

Maconochie¹,

Aickin²,

Hazinski³

et al. 2020

Resuscitation

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This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation. Systematic reviews performed for this 2020 CoSTR for pediatric life support included the topics of sequencing of airway-breaths-compressions versus compressions-airway-breaths in the delivery of pediatric basic life support, the initial timing and dose intervals for epinephrine administration during resuscitation, and the targets for oxygen and carbon dioxide levels in pediatric patients after return of spontaneous circulation. The most controversial topics included the initial timing and dose intervals of epinephrine administration (new treatment recommendations were made) and the administration of fluid for infants and children with septic shock (this latter topic was evaluated by evidence update). All evidence reviews identified the paucity of pediatric data and the need for more research involving resuscitation of infants and children.

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“…For the critical outcome of survival to 30 days with favorable neurological outcome, we identified low-certainty evidence (downgraded for risk of bias and inconsistency) from 7 observational studies 188 , 189 , 190 , 191 , 192 , 193 , 194 enrolling 43 116 patients demonstrating improved survival with a PAD program (OR, 6.60; 95% CI, 3.54–12.28).…”

Section: Defibrillationmentioning

confidence: 99%

Adult Basic Life Support

Berg¹,

Soar²,

Andersen³

et al. 2020

Resuscitation

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This 2020 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care Science With Treatment Recommendations on basic life support summarizes evidence evaluations performed for 20 topics that were prioritized by the Basic Life Support Task Force of the International Liaison Committee on Resuscitation. The evidence reviews include 16 systematic reviews, 3 scoping reviews, and 1 evidence update. Per agreement within the International Liaison Committee on Resuscitation, new or revised treatment recommendations were only made after a systematic review. Systematic reviews were performed for the following topics: dispatch diagnosis of cardiac arrest, use of a firm surface for CPR, sequence for starting CPR (compressions-airway-breaths versus airway-breaths-compressions), CPR before calling for help, duration of CPR cycles, hand position during compressions, rhythm check timing, feedback for CPR quality, alternative techniques, public access automated external defibrillator programs, analysis of rhythm during chest compressions, CPR before defibrillation, removal of foreign-body airway obstruction, resuscitation care for suspected opioid-associated emergencies, drowning, and harm from CPR to victims not in cardiac arrest. The topics that resulted in the most extensive task force discussions included CPR during transport, CPR before calling for help, resuscitation care for suspected opioid-associated emergencies, feedback for CPR quality, and analysis of rhythm during chest compressions. After discussion of the scoping reviews and the evidence update, the task force prioritized several topics for new systematic reviews.

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Location of arrest and survival from out-of-hospital cardiac arrest among children in the public-access defibrillation era in Japan

Cited by 25 publications

References 29 publications

Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

Poor Long-Term Survival of Out-of-Hospital Cardiac Arrest in Children

Pediatric Life Support

Adult Basic Life Support

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