Pre-hospital airway management and survival outcomes after paediatric out-of-hospital cardiac arrests

Tham, Lai Peng; Fook‐Chong, S.; Shahidah, Nur; Ho, Andrew Fu Wah; Tanaka, Hideharu; Shin, Sang Do; Ko, Patrick Chow-In; Wong, Kwanhathai Darin; Jirapong, Supasaowapak; Rao, GV Ramana; Cai, Wenwei; Qahtani, Saad Al; Ong, Marcus Eng Hock

doi:10.1016/j.resuscitation.2022.04.018

Cited by 12 publications

(8 citation statements)

References 30 publications

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“…Bystanders will perform CPR by chance, whereas rst responers perform CPR by system. In this cohort advanced airway management (AAM) had higher aOR of hospital admission with ROSC, whereas it was not associated with survival in other systems (4.6% vs 5.1%) [2,27]. These ndings have been repreated throughout different systems.…”

Section: Demographic Overviewmentioning

confidence: 84%

Out-of-hospital cardiac arrest in children: An epidemiological study based on the German Resuscitation Registry identifying modifiable factors for return of spontaneous circulation

Katzenschlager

Kelpanides

Ristau

et al. 2023

Preprint

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Aim This work provides an epidemiological overview of out-of-hospital cardiac arrest (OHCA) in children in Germany between 2007 and 2021. We wanted to identify modifiable factors associated with survival. Methods Data from the German Resuscitation Registry (GRR) was used, and we included patients registered between 1st January 2007 and 31st December 2021. We included children aged > 7 days and < 18 years, where cardiopulmonary resuscitation (CPR) was started and treatment was continued by emergency medical services (EMS). Incidences and descriptive analyses are presented for the overall cohort and each age group. Multivariate binary logistic regression was performed on the whole cohort to determine the influence of (1) CPR with/without ventilation started by bystander, (2) OHCA witnessed status, and (3) nighttime on the outcome hospital admission with ROSC. Results OHCA in children aged < 1 year had the highest incidence per 100 000 inhabitants, with 23.42, accounting for 42.0% of all included cases. Overall, hypoxia was the leading presumed cause of OHCA; whereas trauma and drowning accounted for a high proportion in children aged > 1 year. Bystander-witnessed OHCA and bystander CPR rate were highest in children aged 1–4 years, with 43.9% and 62.3%, respectively. In reference to EMS-started CPR, bystander CPR with ventilation were associated with an increased odds ratio for ROSC at hospital admission after adjusting for age, sex, year of OHCA and location of OHCA. Conclusion This study provides an epidemiological overview of OHCA in children in Germany and identifies bystander CPR with ventilation as one primary factor for survival. Trial registrations German Clinical Trial Register: DRKS00030989, December 28th 2022.

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Section: Demographic Overviewmentioning

confidence: 84%

Out-of-hospital cardiac arrest in children: An epidemiological study based on the German Resuscitation Registry identifying modifiable factors for return of spontaneous circulation

Katzenschlager

Kelpanides

Ristau

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…To the Editor, We thank the authors, Li Yifang et al, for their interest in our paper: Pre-hospital airway management and survival outcomes after paediatric out-of-hospital cardiac arrests. 1 We agree that resuscitation time bias had been studied using time-dependent propensity score and risk-set matching in a paediatric airway management study. 2 We did not perform time-dependent propensity score matching as the data on time of advanced airway insertion was not consistently available for all patients.…”

mentioning

confidence: 85%

“…The result had been reported and published as supplementary data. 1 The baseline characteristics of the propensity score matched cohort are presented in Table 1. The advanced airway management (AAM) group, consisting of patients who received endotracheal intubations (ETI) and supraglottic airways (SGA) were associated with lower survival with favourable neurological outcome (Cerebral Performance Category (CPC) 1 or 2) [AAM: 8/396 (2.0%) versus BVM: 19/396 (4.8%); adjusted odds ratio (aOR), 0.39 (95% CI 0.17-0.91); p = 0.03] though not in 1-month survival [AAM: 28/ 396 (7.1%) versus BVM: 40/396 (10.1%); aOR 0.67 (95% CI 0.41-1.12); p = 0.126] when compared with bag-valve-mask (BVM) ventilations (Table 2).…”

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confidence: 99%

“…There were 282 patients that achieved pre-hospital ROSC in our study, and the data on duration of resuscitation at scene/en-route was only available for 140 patients with pre-hospital ROSC. 1 It cannot be assumed that the duration of resuscitation calculated would be representative of the whole cohort of patients that achieved prehospital ROSC. The proportions of patients that achieved pre-hospital ROSC in the AAM group was higher than in the BVM group.…”

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confidence: 99%

“…However, lower 1-month survival and survival with CPC 1 or 2 was observed in the AAM group compared to BVM group for the whole unmatched cohort. 1 The median (IQR) scene time (available for 745 patients) was also longer in the patients that received AAM compared to BVM [AAM: 13 min (9-18) versus BVM: 7 min (4-11); p < 0.001]. An observational study had evaluated the effect of resuscitative time at the scene on survival outcomes and found that longer on-scene resuscitation was associated with decreased 1-month survival, adjusted for AAM and other confounders.…”

mentioning

confidence: 99%

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