Survival After Out‐of‐Hospital Cardiac Arrest in Children

Jayaram, Natalie; McNally, Bryan; Tang, Fengming; Chan, Paul S.

doi:10.1161/jaha.115.002122

Cited by 109 publications

(80 citation statements)

References 22 publications

(40 reference statements)

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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: 72%

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: 72%

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

et al. 2020

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“…1,23 We did not include sex or socioeconomic status, because previous researchers have suggested that they are unrelated to survival in OHCA. 2,4,24 The model for injured patients included injury severity score, a negative predictor of survival in trauma. 19 We investigated whether survival could be moderated by teaching hospital status among noninjured patients, hypothesizing that treatment at a teaching hospital might be associated with a survival advantage for children with OHCA.…”

Section: Main Analysesmentioning

confidence: 99%

“…3,7 Despite improvements in regional care and treatment algorithms for cardiac arrest, survival has not improved over the last decade. 4 Children with both in-hospital cardiac arrest and OHCA have been shown in some studies to have improved outcomes at pediatric hospitals. 8 -10 However, it is unclear if the improved outcomes are due to significant differences between patients presenting to pediatric versus general emergency departments (EDs).…”

mentioning

confidence: 99%

Cardiac Arrest Survival in Pediatric and General Emergency Departments

et al. 2018

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“…1,2 Survival from pediatric out-of-hospital cardiac arrest (P-OHCA) has typically been estimated between 6–12% and, when compared to adults, survival is lower in infants and higher in adolescents. 1,3–5 …”

Section: Introductionmentioning

confidence: 99%

A comparison of pediatric airway management techniques during out-of-hospital cardiac arrest using the CARES database

et al. 2017

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Objective To compare odds of survival to hospital discharge among pediatric out-of-hospital cardiac arrest (OHCA) patients receiving either bag-valve-mask ventilation (BVM), supraglottic airway (SGA) or endotracheal intubation (ETI), after adjusting for the propensity to receive a given airway intervention. Methods Retrospective cohort study using the Cardiac Arrest Registry to Enhance Survival (CARES) database from January 1 2013– December 31 2015. The CARES registry includes data on cardiac arrests from 17 statewide registries and approximately 55 additional US cities. We included patients less than18 years of age who suffered a non-traumatic OHCA and received a resuscitation attempt by Emergency Medical Services (EMS). The key exposure was the airway management strategy (BVM, ETI, or SGA). The primary outcome was survival to hospital discharge. Results Of the 3,793 OHCA cases included from 405 EMS agencies, 1724 cases were analyzed after limiting the analysis to EMS agencies that used all 3 devices. Of the 1724, 781 (45.3%) were treated with BVM only, 727 (42.2%) ETI, and 215 (12.5%) SGA. Overall, 20.7% had ROSC and 10.9% survived to hospital discharge. After using a propensity score analysis, the odds ratio for survival to hospital discharge for ETI compared to BVM was 0.39 (95%CI 0.26–0.59) and for SGA compared to BVM was 0.32 (95% CI 0.12–0.84). These relationships were robust to the sensitivity analyses including complete case, EMS-agency matched, and age-stratified. Conclusions BVM was associated with higher survival to hospital discharge compared to ETI and SGA. A large randomized clinical trial is needed to confirm these findings.

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Survival After Out‐of‐Hospital Cardiac Arrest in Children

Cited by 109 publications

References 22 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

Cardiac Arrest Survival in Pediatric and General Emergency Departments

A comparison of pediatric airway management techniques during out-of-hospital cardiac arrest using the CARES database

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