Brief report: incidence and outcomes of pediatric tracheal intubation-associated cardiac arrests in the ICU-RESUS clinical trial.

Autor: Nishisaki A; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA. nishisaki@chop.edu., Reeder RW; Department of Pediatrics, University of Utah, Salt Lake City, UT, USA., McGovern EL; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Ahmed T; Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI, USA., Bell MJ; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA., Bishop R; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA., Bochkoris M; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA., Burns C; Department of Pediatrics and Human Development, Michigan State University, Grand Rapids, MI, USA., Carcillo JA; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA., Carpenter TC; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA., Diddle W; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Federman M; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA., Fink EL; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA., Franzon D; Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA, USA., Frazier AH; Nemours Cardiac Center, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE, USA.; Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA., Friess SH; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA., Graham K; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Hall M; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA., Hehir DA; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Horvat CM; Department of Critical Care Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, PA, USA., Huard LL; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA., Maa T; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA., Manga A; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA., McQuillen P; Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA, USA., Meert KL; Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI, USA., Morgan RW; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Mourani PM; Department of Pediatrics, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR, USA., Nadkarni VM; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Naim MY; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Notterman D; Department of Molecular Biology, Princeton University, Princeton, NJ, USA., Palmer CA; Department of Pediatrics, University of Utah, Salt Lake City, UT, USA., Sapru A; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA., Schneiter C; Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, USA., Sharron MP; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA., Srivastava N; Department of Pediatrics, Mattel Children's Hospital, University of California Los Angeles, Los Angeles, CA, USA., Viteri S; Department of Pediatrics, Nemours/Alfred I. duPont Hospital for Children and Thomas Jefferson University, Wilmington, DE, USA., Wessel D; Department of Pediatrics, Children's National Hospital, George Washington University School of Medicine, Washington, DC, USA., Wolfe HA; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Yates AR; Department of Pediatrics, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA., Zuppa AF; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Sutton RM; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA., Berg RA; Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2024 Aug 30; Vol. 28 (1), pp. 286. Date of Electronic Publication: 2024 Aug 30.
DOI: 10.1186/s13054-024-05065-0
Abstrakt: Background: Tracheal intubation (TI)-associated cardiac arrest (TI-CA) occurs in 1.7% of pediatric ICU TIs. Our objective was to evaluate resuscitation characteristics and outcomes between cardiac arrest patients with and without TI-CA.
Methods: Secondary analysis of cardiac arrest patients in both ICU-RESUS trial and ancillary CPR-NOVA study. The primary exposure was TI-CA, defined as cardiac arrest occurred during TI procedure or within 20 min after endotracheal tube placement. The primary outcome was survival to hospital discharge with favorable neurological outcome (Pediatric Cerebral Performance Category score 1-3 or unchanged).
Results: Among 315 children with cardiac arrests, 48 (15.2%) met criteria for TI-CA. Pre-existing medical conditions were similar between groups. Pre-arrest non-invasive mechanical ventilation was more common among TI-CA patients (18/48, 37.5%) compared to non-TI-CA patients (35/267, 13.1%). In 48% (23/48), the TI-CA occurred within 20 min after intubation (i.e., not during intubation). Duration of CPR was longer in TI-CA patients (median 11.0 min, interquartile range [IQR]: 2.5, 35.5) than non-TI-CA patients (median 5.0 min, IQR 2.0, 21.0), p = 0.03. Return of spontaneous circulation occurred in 32/48 (66.7%) TI-CA versus 186/267 (69.7%) non-TI-CA, p = 0.73. Survival to hospital discharge with favorable neurological outcome occurred in 29/48 (60.4%) TI-CA versus 146/267 (54.7%) non-TI-CA, p = 0.53.
Conclusions: Fifteen percent of these pediatric ICU cardiac arrests were associated with TI. Half of TI-CA occurred after endotracheal tube placement. While duration of CPR was longer in TI-CA patients, there were no differences in unadjusted outcomes following TI-CA versus non-TI-CA.
Trial Registration: The ICU-RESUS (ClinicalTrials.gov Identifier: NCT02837497).
(© 2024. The Author(s).)
Databáze: MEDLINE
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