Wolfe Heather, Morgan Ryan W, Donoghue Aaron, Niles Dana E, Kudenchuk Peter, Berg Robert A, Nadkarni Vinay M, Sutton Robert M
The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104, United States.
Resuscitation. 2016 Sep;106:65-9. doi: 10.1016/j.resuscitation.2016.06.003. Epub 2016 Jun 25.
Quality cardiopulmonary resuscitation (CPR) is associated with improved outcomes during cardiac arrest. Duty cycle (DC) represents an understudied element of CPR quality. Our objective was to quantitatively analyze DC during actual pediatric and adolescent in-hospital cardiac arrest (IHCA).
Prospective observational study of IHCA at a large academic children's hospital. CPR variables included DC (%) up to the first 10min of recorded chest compressions (CCs). American Heart Association (AHA) DC compliance was prospectively defined as an average event DC of 50±5%. Percentage of events compliant with AHA DC was compared to a priori hypothesized compliance percentage of 25% using chi-square. Association between DC quartiles and categories of depth (<38, 38-49, ≥50mm) and rate (<100, 100-120, >120min(-1)) were analyzed by chi-square test for trend.
Between October 2006 and June 2015, 97 events in 87 patients were analyzed. Mean DC for events was 40±2.8%. DC quartiles: Q1 (DC ≤38.3%), Q2 (>38.3-40.1%), Q3 (>40.1-42.1%), Q4 (>42.1%). Only 5 (5.2%) events met AHA DC compliance, significantly less than the a priori hypothesis of 25% (p<0.001). Average CC rates trended higher across DC quartiles: (Q1) 105±9; (Q2) 106±9; (Q3) 112±8; and (Q4) 118±14min(-1); p<0.001. Other CPR quality variables were not associated with DC. There was no association between DC and survival.
Compression DC during resuscitation of actual child and adolescent IHCA met AHA recommendations in only 5% of events. In this series we found no association of DC with CC depth or survival.
高质量的心肺复苏（CPR）与心脏骤停期间改善的预后相关。 duty cycle（DC）是CPR质量中一个研究较少的要素。我们的目的是定量分析实际儿科和青少年住院心脏骤停（IHCA）期间的DC。
在一家大型学术儿童医院对IHCA进行前瞻性观察研究。CPR变量包括记录的胸外按压（CC）前10分钟内的DC（%）。美国心脏协会（AHA）的DC依从性前瞻性定义为平均事件DC为50±5%。使用卡方检验将符合AHA DC的事件百分比与先验假设的25%依从率进行比较。通过卡方趋势检验分析DC四分位数与深度类别（<38、38 - 49、≥50mm）和速率类别（<100、100 - 120、>120次/分钟）之间的关联。
2006年10月至2015年6月期间，分析了87例患者的97次事件。事件的平均DC为40±2.8%。DC四分位数：Q1（DC≤38.3%），Q2（>38.3 - 40.1%），Q3（>40.1 - 42.1%），Q4（>42.1%）。只有5次（5.2%）事件符合AHA DC依从性，显著低于先验假设的25%（p<0.001）。平均CC速率在DC四分位数中呈上升趋势：（Q1）105±9；（Q2）106±9；（Q3）112±8；（Q4）118±14次/分钟；p<0.001。其他CPR质量变量与DC无关。DC与生存率之间无关联。
实际儿童和青少年IHCA复苏期间的按压DC仅在5%的事件中符合AHA建议。在本系列研究中，我们发现DC与CC深度或生存率无关联。
