Association between survival and number of shocks for pulseless ventricular arrhythmias during pediatric in-hospital cardiac arrest in a national registry.

Autor: Haskell SE; University of Iowa Carver College of Medicine, Iowa City, IA, United States. Electronic address: sarah-haskell@uiowa.edu., Hoyme D; University of Wisconsin Madison School of Medicine, Madison, WI, United States., Zimmerman MB; University of Iowa College of Public Health, Iowa City, IA, United States., Reeder R; University of Utah School of Medicine, Salt Lake City, UT, United States., Girotra S; UT Southwestern Medical Center, Dallas, TX, United States., Raymond TT; Medical City Children's Hospital, Dallas, TX, United States., Samson RA; Children's Heart Center, Nevada, Las Vegas, NV, United States., Berg M; Stanford School of Medicine, Palo Alto, CA, United States., Berg RA; Children's Hospital of Philadelphia, Philadelphia, PA, United States., Nadkarni V; Children's Hospital of Philadelphia, Philadelphia, PA, United States., Atkins DL; University of Iowa Carver College of Medicine, Iowa City, IA, United States.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2024 May; Vol. 198, pp. 110200. Date of Electronic Publication: 2024 Apr 04.
DOI: 10.1016/j.resuscitation.2024.110200
Abstrakt: Background: Annually 15,200 children suffer an in-hospital cardiac arrest (IHCA) in the US. Ventricular fibrillation or pulseless ventricular tachycardia (VF/pVT) is the initial rhythm in 10-15% of these arrests. We sought to evaluate the association of number of shocks and early dose escalation with survival for initial VF/pVT in pediatric IHCA.
Methods: Using 2000-2020 data from the American Heart Association's (AHA) Get with the Guidelines®-Resuscitation (GWTG-R) registry, we identified children >48 hours of life and ≤18 years who had an IHCA from initial VF/pVT and received defibrillation.
Results: There were 251 subjects (37.7%) who received a single shock and 415 subjects (62.3%) who received multiple shocks. Baseline and cardiac arrest characteristics did not differ between those who received a single shock versus multiple shocks except for duration of arrest and calendar year. The median first shock dose was consistent with AHA dosing recommendations and not different between those who received a single shock versus multiple shocks. Survival was improved for those who received a single shock compared to multiple shocks. However, no difference in survival was noted between those who received 2, 3, or ≥4 shocks. Of those receiving multiple shocks, no difference was observed with early dose escalation.
Conclusions: In pediatric IHCA, most patients with initial VF/pVT require more than one shock. No distinctions in patient or pre-arrest characteristics were identified between those who received a single shock versus multiple shocks. Subjects who received a single shock were more likely to survive to hospital discharge even after adjusting for duration of resuscitation.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ‘Tia Raymond reports she is a paid consultant of New England Research Institutes, Inc., as a member of the adjudication committee for the COMPASS Trial (Comparison of Methods for Pulmonary Blood Flow Augmentation in Neonates: Shunt versus Stent. Dianne Atkins reports she is a paid member of the Data Monitoring Safety Board for the Pediatric Heart Network, a multicenter study funded by NHLBI’.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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