Berens Richard J, Cassidy Laura D, Matchey Jennifer, Campbell Deborah, Colpaert Krista D, Welch Tangela, Lawson Michelle, Peterson Cheryl, O'Flynn Justine, Dearth Mary, Tieves Kelly S
Medical College of Wisconsin, Milwaukee WI, USA.
Paediatr Anaesth. 2011 Aug;21(8):834-40. doi: 10.1111/j.1460-9592.2010.03479.x. Epub 2010 Dec 28.
To aggregate data across institutions to identify, characterize, and differentiate potential survivors from nonsurvivors based on etiology of event.
To evaluate the association of the cardiopulmonary resuscitation (CPR) duration and probability of survival (Ps), stratified by etiology of arrest.
In-hospital cardiac arrests occur in 2-6% of pediatric patients with poor survival rates resulting in significant expenditures of time and resources.
Retrospective data from six pediatric hospitals on patients suffering from pulseless cardiac arrests receiving CPR for over one minute were analyzed. Data included demographics, reason for code, precardiac arrest diagnosis, devices and treatment, management strategies during cardiac arrest, compression duration, outcome at hospital discharge, and neurologic outcome of survivors at hospital discharge. Results of logistic regression analysis generated predicated probabilities of survival for duration of compression. Patients were stratified by cardiac-induced cardiac arrests (CICA) and respiratory-induced cardiac arrest (RICA).
A total of 257 patients were included, and 27% of CICA and 35% of RICA patients survived to hospital discharge. Ps was initially lower for the CICA patients (Ps at 1 min = 29%) and remained constant (Ps at 60 min = 25%). RICA patients'Ps was higher initially (Ps at 1 min = 62%) but demonstrated a dramatic drop within the first 60 min of CPR (Ps at 60 min = 0.2%).
Probability of survival curves based on duration of CPR was statistically significantly different for CICA patients compared to RICA patients.
汇总各机构的数据，根据事件病因识别、描述并区分潜在幸存者与非幸存者。
评估心肺复苏（CPR）持续时间与生存概率（Ps）之间的关联，并按心脏骤停病因进行分层。
2% - 6%的儿科患者会发生院内心脏骤停，生存率较低，导致时间和资源的大量消耗。
分析了六家儿科医院中接受CPR超过一分钟的无脉性心脏骤停患者的回顾性数据。数据包括人口统计学信息、急救原因、心脏骤停前诊断、设备及治疗、心脏骤停期间的管理策略、按压持续时间、出院时的结局以及出院时幸存者的神经学结局。逻辑回归分析结果得出了按压持续时间的预测生存概率。患者按心脏源性心脏骤停（CICA）和呼吸源性心脏骤停（RICA）进行分层。
共纳入257例患者，27%的CICA患者和35%的RICA患者存活至出院。CICA患者的Ps最初较低（1分钟时Ps = 29%）且保持不变（60分钟时Ps = 25%）。RICA患者的Ps最初较高（1分钟时Ps = 62%），但在CPR的前60分钟内急剧下降（60分钟时Ps = 0.2%）。
与RICA患者相比，CICA患者基于CPR持续时间的生存概率曲线在统计学上有显著差异。
