TY - JOUR
T1 - Association of chest compression pause duration prior to E-CPR cannulation with cardiac arrest survival outcomes
AU - Lauridsen, Kasper G.
AU - Lasa, Javier J.
AU - for the pediRES-Q Investigators
AU - Raymond, Tia T.
AU - Yu, Priscilla
AU - Niles, Dana
AU - Sutton, Robert M.
AU - Morgan, Ryan W.
AU - Fran Hazinski, Mary
AU - Griffis, Heather
AU - Hanna, Richard
AU - Zhang, Xuemei
AU - Berg, Robert A.
AU - Nadkarni, Vinay M.
AU - Abulebda, Kamal
AU - Atkins, Diane
AU - Balikai, Shilpa
AU - Berg, Marc
AU - Berg, Robert
AU - Bhalala, Utpal
AU - Braga, Matthew S.
AU - Buysse, Corinne
AU - Cheng, Adam
AU - Christoff, Andrea
AU - Corbett, Kelly
AU - DeCaen, Allan
AU - Daniels, Katherine
AU - deJong, Gabry
AU - del Castillo, Jimena
AU - Dewan, Maya
AU - Donoghue, Aaron
AU - Esangbedo, Ivie
AU - Flaherty, Michael
AU - Friess, Stuart
AU - Gangadharan, Sandeep
AU - Gawronski, Orsola
AU - Gilleland, Jonathan
AU - Gray, James
AU - Harvey, Helen
AU - Harwayne-Gidansky, Ilana
AU - Haskell, Sarah
AU - Hayes, Jennifer
AU - Heber, Kiran
AU - Hunt, Betsy
AU - Ikeyama, Takanari
AU - Jani, Priti
AU - Kleinman, Monica
AU - Knight, Lynda
AU - Kurosawa, Hiroshi
AU - Glerup Lauridsen, Kasper
AU - Morgan, Ryan W.
N1 - Funding
The pediRES-Q is supported by an unrestricted research grant to the Children’s Hospital of Philadelphia from ZOLL Medical. The sponsor had no role in the design, interpretation, writing, editing, or submission of the manuscript.
Publisher Copyright: © 2022 The Author(s)
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Objective: To characterize chest compression (CC) pause duration during the last 5 minutes of pediatric cardiopulmonary resuscitation (CPR) prior to extracorporeal-CPR (E-CPR) cannulation and the association with survival outcomes. Methods: Cohort study from a resuscitation quality collaborative including pediatric E-CPR cardiac arrest events ≥ 10 min with CPR quality data. We characterized CC interruptions during the last 5 min of defibrillator-electrode recorded CPR (prior to cannulation) and assessed the association between the longest CC pause duration and survival outcomes using multivariable logistic regression. Results: Of 49 E-CPR events, median age was 2.0 [Q1, Q3: 0.6, 6.6] years, 55% (27/49) survived to hospital discharge and 18/49 (37%) with favorable neurological outcome. Median duration of CPR was 51 [43, 69] min. During the last 5 min of recorded CPR prior to cannulation, median duration of the longest CC pause was 14.0 [6.3, 29.4] sec: 66% >10 sec, 25% >29 sec, 14% >60 sec, and longest pause 168 sec. Following planned adjustment for known confounders of age and CPR duration, each 5-sec increase in longest CC pause duration was associated with lower odds of survival to hospital discharge [adjusted OR 0.89, 95 %CI: 0.79–0.99] and lower odds of survival with favorable neurological outcome [adjusted OR 0.77, 95 %CI: 0.60–0.98]. Conclusions: Long CC pauses were common during the last 5 min of recorded CPR prior to E-CPR cannulation. Following adjustment for age and CPR duration, each 5-second incremental increase in longest CC pause duration was associated with significantly decreased rates of survival and favorable neurological outcome.
AB - Objective: To characterize chest compression (CC) pause duration during the last 5 minutes of pediatric cardiopulmonary resuscitation (CPR) prior to extracorporeal-CPR (E-CPR) cannulation and the association with survival outcomes. Methods: Cohort study from a resuscitation quality collaborative including pediatric E-CPR cardiac arrest events ≥ 10 min with CPR quality data. We characterized CC interruptions during the last 5 min of defibrillator-electrode recorded CPR (prior to cannulation) and assessed the association between the longest CC pause duration and survival outcomes using multivariable logistic regression. Results: Of 49 E-CPR events, median age was 2.0 [Q1, Q3: 0.6, 6.6] years, 55% (27/49) survived to hospital discharge and 18/49 (37%) with favorable neurological outcome. Median duration of CPR was 51 [43, 69] min. During the last 5 min of recorded CPR prior to cannulation, median duration of the longest CC pause was 14.0 [6.3, 29.4] sec: 66% >10 sec, 25% >29 sec, 14% >60 sec, and longest pause 168 sec. Following planned adjustment for known confounders of age and CPR duration, each 5-sec increase in longest CC pause duration was associated with lower odds of survival to hospital discharge [adjusted OR 0.89, 95 %CI: 0.79–0.99] and lower odds of survival with favorable neurological outcome [adjusted OR 0.77, 95 %CI: 0.60–0.98]. Conclusions: Long CC pauses were common during the last 5 min of recorded CPR prior to E-CPR cannulation. Following adjustment for age and CPR duration, each 5-second incremental increase in longest CC pause duration was associated with significantly decreased rates of survival and favorable neurological outcome.
UR - http://www.scopus.com/inward/record.url?scp=85132242386&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2022.05.004
DO - 10.1016/j.resuscitation.2022.05.004
M3 - Article
C2 - 35588971
AN - SCOPUS:85132242386
SN - 0300-9572
VL - 177
SP - 85
EP - 92
JO - Resuscitation
JF - Resuscitation
ER -