Evaluation of hospital management of paediatric out-of-hospital cardiac arrest.
CPR
Cardiac arrest
Deviations
Guidelines
Pediatric Advanced Life Support
Pediatrics
Journal
Resuscitation plus
ISSN: 2666-5204
Titre abrégé: Resusc Plus
Pays: Netherlands
ID NLM: 101774410
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
04
04
2023
revised:
22
06
2023
accepted:
11
07
2023
medline:
9
8
2023
pubmed:
9
8
2023
entrez:
9
8
2023
Statut:
epublish
Résumé
Pediatric out of hospital cardiac arrest (POHCA) is rare, with high mortality and neurological morbidity. Adherence to Pediatric Advanced Life Support guidelines standardizes in-hospital care and improves outcomes. We hypothesized that in-hospital care of POHCA patients was variable and deviations from guidelines were associated with higher mortality. POHCA patients in the London-Middlesex region between January 2012 and June 2020 were included. The care of children with ongoing arrest (intra-arrest) and post-arrest outcomes were reviewed using the Children's Hospital, London Health Sciences Centre (LHSC) patient database and the Adverse Event Management System. 50 POHCA patients arrived to hospital, with 15 (30%) patients admitted and 2 (4.0%) surviving to discharge, both with poor neurological outcomes and no improvement at 90 days. Deviations occurred at every event with intra-arrest care deviations occurring mostly in medication delivery and defibrillation (98%). Post-arrest deviations occurred mostly in temperature monitoring (60%). Data missingness was 15.9% in the intra-arrest and 1.7% in the post-arrest group. Deviations commonly occurred in both in-hospital arrest and post-arrest care. The study was under-powered to identify associations between DEVs and outcomes. Future work includes addressing specific deviations in intra-arrest and post-arrest care of POHCA patients and standardizing electronic documentation.
Identifiants
pubmed: 37555196
doi: 10.1016/j.resplu.2023.100433
pii: S2666-5204(23)00076-0
pmc: PMC10405089
doi:
Types de publication
Journal Article
Langues
eng
Pagination
100433Informations de copyright
© 2023 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Resuscitation. 2012 Jan;83(1):63-9
pubmed: 21963583
Eur Heart J Cardiovasc Pharmacother. 2018 Jul 1;4(3):144-151
pubmed: 29036580
JAMA. 2013 Oct 2;310(13):1377-84
pubmed: 24084923
Eff Clin Pract. 2001 Sep-Oct;4(5):207-13
pubmed: 11685978
Resuscitation. 2020 Nov;156:223-229
pubmed: 32652117
JAMA. 2005 Jan 19;293(3):305-10
pubmed: 15657323
Resuscitation. 2020 Apr;149:89-99
pubmed: 32057946
Resuscitation. 2014 Sep;85(9):1179-84
pubmed: 24842846
Resuscitation. 2015 Oct;95:100-47
pubmed: 26477701
Circulation. 2005 Aug 30;112(9):1259-65
pubmed: 16116053
Circulation. 2002 Feb 5;105(5):645-9
pubmed: 11827933
Pediatr Crit Care Med. 2019 May;20(5):405-416
pubmed: 30672841
JAMA. 2005 Jan 19;293(3):299-304
pubmed: 15657322
Circulation. 1987 Feb;75(2):491-7
pubmed: 3802451
Acad Emerg Med. 2006 Jun;13(6):653-8
pubmed: 16670256
Front Pediatr. 2022 Feb 22;10:826294
pubmed: 35273929
JAMA. 2015 Aug 25;314(8):802-10
pubmed: 26305650
Int Heart J. 2020 Mar 28;61(2):254-262
pubmed: 32173714
Ann Emerg Med. 1985 Mar;14(3):204-8
pubmed: 3977143
Pediatr Crit Care Med. 2010 Nov;11(6):723-30
pubmed: 20431503
Pediatrics. 2009 Aug;124(2):494-9
pubmed: 19581266
Resuscitation. 2016 Apr;101:77-83
pubmed: 26876006
Prehosp Emerg Care. 2002 Jul-Sep;6(3):283-90
pubmed: 12109569
Resuscitation. 2005 Mar;64(3):297-301
pubmed: 15733757
Pediatrics. 2004 Jul;114(1):157-64
pubmed: 15231922
Circulation. 2020 Oct 20;142(16_suppl_2):S469-S523
pubmed: 33081526
Front Pediatr. 2019 Jul 16;7:294
pubmed: 31380327
Am J Respir Crit Care Med. 2021 Oct 15;204(8):977-985
pubmed: 34265230
Circulation. 2019 Aug 6;140(6):e194-e233
pubmed: 31242751
Front Pediatr. 2016 Apr 18;4:38
pubmed: 27148507
Resuscitation. 2010 Dec;81(12):1664-9
pubmed: 20727657
JAMA. 2008 Mar 12;299(10):1158-65
pubmed: 18334691
J Am Coll Cardiol. 2011 May 3;57(18):1822-8
pubmed: 21527156
Crit Care Med. 2014 Jun;42(6):1518-23
pubmed: 24561563
Resuscitation. 2007 Sep;74(3):453-60
pubmed: 17386966
Resuscitation. 2016 Oct;107:121-8
pubmed: 27565862
JAMA. 1999 Oct 20;282(15):1458-65
pubmed: 10535437
Circulation. 2005 Feb 1;111(4):428-34
pubmed: 15687130
Resuscitation. 2002 Apr;53(1):47-51
pubmed: 11947979
Resuscitation. 2002 Apr;53(1):21-7
pubmed: 11947975
Resuscitation. 2007 Apr;73(1):54-61
pubmed: 17258853
Crit Care Med. 2014 Jul;42(7):1688-95
pubmed: 24717462
Circulation. 2018 May 8;137(19):2032-2040
pubmed: 29511001
Pharmacotherapy. 2006 Feb;26(2):214-28
pubmed: 16466326
Arch Dis Child Fetal Neonatal Ed. 2010 Jul;95(4):F295-303
pubmed: 19776023
BMC Med. 2009 Feb 06;7:6
pubmed: 19200355
Circulation. 2011 Jul 5;124(1):58-66
pubmed: 21690495
Circulation. 2001 Nov 13;104(20):2465-70
pubmed: 11705826
Circulation. 2009 Mar 24;119(11):1484-91
pubmed: 19273724
J Am Heart Assoc. 2018 Dec 18;7(24):e009860
pubmed: 30561251
Circulation. 2018 May 8;137(19):2041-2051
pubmed: 29279412