Pediatric Cardiopulmonary Resuscitation: A Collective Review

Young, Kelly D.; Seidel, James S.

doi:10.1016/s0196-0644(99)70394-x

Cited by 327 publications

(173 citation statements)

References 68 publications

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“…The disparity between the different cardiac arrest survival rates suggests a need to stress application of CPR by any available individual in the pediatric setting. 2,12,15 The poor outcomes for children who achieve return of spontaneous circulation only after application of advanced life support interventions demands increased emphasis on basic life support training for anyone who has more than casual contact with children. 15,17,20,21 Pediatricians can improve overall community health by advocating for basic life support training for resuscitation of child and adult cardiac arrest victims and by participating in basic life support courses as students and teachers.…”

Section: Discussionmentioning

confidence: 99%

“…13 The available information suggests that outcomes will improve for the newly apneic or fibrillating child who receives prompt CPR. 2 The guidance in this report does not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate.…”

mentioning

confidence: 97%

“…1 Pediatric out-of-hospital cardiac arrest carries a poor prognosis, which seems to be improved only by onscene application of basic life support. 2 New information regarding sudden infant death syndrome (SIDS) and sudden cardiac death in children prompts careful attention to the role of the public in the chain of survival for an infant or child who experiences cardiac arrest. [3][4][5][6] Ventricular fibrillation has been newly considered as an important cause of cardiac arrest in children and adolescents in several recent studies, 3,7 which underscores the importance of basic life support training for the public, because cardiopulmonary resuscitation (CPR) before attempted defibrillation may improve the chances of successful defibrillation.…”

mentioning

confidence: 99%

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Role of Pediatricians in Advocating Life Support Training Courses for Parents and the Public

Pyles¹,

Knapp²

2004

Pediatrics

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 97%

mentioning

confidence: 99%

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Role of Pediatricians in Advocating Life Support Training Courses for Parents and the Public

Pyles¹,

Knapp²

2004

Pediatrics

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“…Buna karşın hastane içi kardiyak arrestlerde sağ kalım oranı %27'lere ulaşmıştır. Genelde hastanelerde riskli hastaların daha erken belirlenmesi, bu hastaların daha iyi yönetilmesi ve güncel canlandırma kı-lavuzlarının daha etkin uygulanmasının bu duruma yol açtığı düşünülmekle birlikte kesin nedeni açık değildir (1)(2)(3)(4)(5)(6)(7).…”

Section: Introductionunclassified

Early Mortality Predictors for Children Receiving Advanced Life Support in Emergency Department

Anıl¹,

Köse²,

Köse³

et al. 2014

Turk J Ped Em Int Care Med

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ÖZETAmaç: Acil serviste ileri yaşam desteği uygulanan çocukların özelliklerinin, prognostik faktörlerin ve erken dönem sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: 01.06.2011 ile 31.05.2012 tarihleri arasında acil serviste ileri yaşam desteği uygulanan çocuk-lar geriye dönük olarak değerlendirilmiştir. Hastaların klinik özellikleri, başvuru anında elde edilen laboratuvar değişkenleri ve ilk 24 saat içindeki mortalite belirteçleri analiz edilmiştir. Bulgular: İleri yaşam desteği sıklığı %0,03'dür. Hastaların 16'sı travma hastası olup, 21'nde kronik hastalık mevcuttur. İleri yaşam desteği uygulanan 46 hastanın 15'i ilk 24 saat içinde ölmüştür. Ölen ve yaşayan hastaların ortanca yaşları sırasıyla 8 ve 30 aydır (p<0,05). İlk 24 saat içinde yaşayan ve ölen hastalar arasında, epinefrin enjeksiyon sayısı, kan glikoz, C-reaktif protein, bikarbonat, baz fazlalılığı ve laktat düzeyleri anlamlı olarak farklıdır (p<0,05). Lojistik regresyon analizinde, yüksek epinefrin enjeksiyon sayısı ve yüksek kan laktat düzeyi erken dönem mortalitenin göstergesidir (p<0,05). ROC analizinde, epinefrin enjeksiyon sayısı ve kan laktat düzeyi için eğri altında kalan alanın büyüklüğü sırasıyla 0,900 ve 0,883'dür. Sonuç: Epinefrin enjeksiyon sayısı ve acil servise başvuru sırasında elde edilen kan laktat düzeyi ilk 24 saat içinde-ki mortalite göstergeleridir (CAYD 2014; 1(1):17-24). Anahtar Kelimeler: İleri yaşam desteği, çocuk acil servisi, epinefrin, laktat SUMMARY Introduction : The characteristics, prognostic factors and early outcomes were evaluated for children receiving advanced life support in emergency department. Material and Methods :We retrospectively evaluated the medical records of 46 children who received advanced life support in emergency department between 06. 01.2011 -05. 31.2012. The clinical and laboratory variables that were available at admission and the predictors of mortality in first 24 hours were analyzed. Results: The incidence of advanced life support was %0,03. Sixteen of them were trauma patients and 21 children had chronic disease. Among the 46 children who received advanced life support, 15 patients were died in first 24 hours. The median age of patients who died and survived were 8 and 30 months (p<0.05). The number of epinephrine injections, the blood levels of glucose, C-reactive protein, bicarbonate, base excess and lactate were significantly different between the survived and death patients in first 24 hours (p<0,05). In logistic regression analysis, the higher numbers of epinephrine injections and higher levels of blood lactate level were identified as predictors of early mortality (p<0.05). The areas under the curve of number of epinephrine injection and blood lactate level were 0.900 and 0.883 in ROC analysis. Conclusions:The number of epinephrine injection and blood lactate level at arrival to the emergency department are the predictors of death in first 24 hours (CAYD 2014; 1(1):17-24).

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“…1 In pediatric patients, the etiology of out-of-hospital CA is more diverse and the age-dependent frequency of VF is not well established. 2,3 However, studies suggest that the proportion of patients presenting with VF is less among the pediatric population. 4 In the current study, we sought to identify the proportion of pediatric CAs presenting with VF according to age.…”

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confidence: 99%

Ventricular Fibrillation in Pediatric Cardiac Arrest

Smith

Rea

Eisenberg

2006

Academic Emergency Medicine

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Objectives: After activating 9-1-1 for out-of-hospital cardiac arrest (CA), guidelines for children 1 year and older have evolved to include immediate automated external defibrillator (AED) use for witnessed arrest, and two minutes of cardiopulmonary resuscitation (CPR) followed by AED use for unwitnessed arrests. The best approach to resuscitation in a two-tiered emergency medical services (EMS) system depends in part on how likely the patient is to present with ventricular fibrillation (VF). Therefore, the authors evaluated the frequency of VF with respect to age and other characteristics to further elucidate the role of the AED among pediatric CAs. Methods:The investigation was a retrospective cohort study of EMS-treated, nontraumatic, out-of-hospital CA among persons aged 1-18 years in King County, Washington, between April 1, 1976, and December 31, 2003. The primary goal was to identify the proportion of patients presenting to EMS in VF, according to age. The association between other characteristics and the likelihood of VF was also evaluated. Finally, hospital survival according to cardiac rhythm at EMS arrival was evaluated.Results: Ventricular fibrillation was the presenting rhythm in 17.6% of cases (48/272). The proportion presenting with VF was 7.6% (10/131) among children aged 1-7 years and 27.0% (38/141) among children aged 8-18 years (p < 0.001). In multivariable models, VF was independently associated with age 8 years and older compared with 1-7 years (odds ratio, 3.19; 95% confidence interval [CI] = 1.46 to 6.97), witnessed arrest (odds ratio, 3.33; 95% CI = 1.63 to 6.82), and cardiac etiology (odds ratio, 2.89; 95% CI = 1.32 to 6.34). Survival was 31.3% (15/48) for VF and 10.7% (24/224) for nonshockable rhythm CAs. Conclusions:The proportion of children aged younger than 8 years presenting with VF is low compared with older children. The greatest increase in VF proportion occurs in children older than 12 years. Based on these results, the best approach for initial EMS resuscitation in a two-tiered EMS system, CPR versus AED use, is uncertain among younger children. Inclusion of witness status into the decision process for younger children may more efficiently allocate AED use, a finding in accordance with 2005 guidelines.ACADEMIC EMERGENCY MEDICINE 2006; 13:525-529 ª

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Pediatric Cardiopulmonary Resuscitation: A Collective Review

Cited by 327 publications

References 68 publications

Role of Pediatricians in Advocating Life Support Training Courses for Parents and the Public

Role of Pediatricians in Advocating Life Support Training Courses for Parents and the Public

Early Mortality Predictors for Children Receiving Advanced Life Support in Emergency Department

Ventricular Fibrillation in Pediatric Cardiac Arrest

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