Division of Critical Care Medicine, Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Children's National Health System, Washington, DC.
Division of Pediatric Critical Care, Department of Pediatrics, University of Virginia Health System, Charlottesville, VA.
Pediatr Crit Care Med. 2018 Sep;19(9):831-838. doi: 10.1097/PCC.0000000000001644.
To assess differences in cardiopulmonary resuscitation quality in classic cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation events using video recordings of actual pediatric cardiac arrest events.
Single-center, prospective, observational trial.
Tertiary-care pediatric teaching hospital, cardiac ICU.
All patients admitted to the pediatric cardiac ICU with cardiopulmonary resuscitation events lasting greater than 2 minutes captured on video.
None.
Seventeen events comprising 264.5 minutes of cardiopulmonary resuscitation were included: 11 classic cardiopulmonary resuscitation events (87.5 min) and six extracorporeal cardiopulmonary resuscitation events (177 min). Events were divided into 30-second epochs, and cardiopulmonary resuscitation quality markers were assessed using video and telemetry data review of goal endpoints: end-tidal carbon dioxide greater than or equal to 15 mm Hg, diastolic blood pressure greater than or equal to 30 mm Hg, chest compression fraction greater than 80% per epoch, and chest compression rate between 100 and 120 chest compression per minute. Additionally, each chest compression pause (hands-off event) was recorded and timed. When compared with extracorporeal cardiopulmonary resuscitation, classic cardiopulmonary resuscitation epochs were more likely to have end-tidal carbon dioxide greater than or equal to 15 mm Hg (56% vs 6.2%; p = 0.01) and provide chest compression between 100 and 120 times per minute (112 vs 134 chest compression per minute; p < 0.001). No difference was found between classic cardiopulmonary resuscitation and extracorporeal cardiopulmonary resuscitation in compliance with diastolic blood pressure greater than or equal to 30 mm Hg (38% classic cardiopulmonary resuscitation vs 30% extracorporeal cardiopulmonary resuscitation). There were 135 hands-off events: 52 in classic cardiopulmonary resuscitation and 83 in extracorporeal cardiopulmonary resuscitation (p = 0.12).
Classic cardiopulmonary resuscitation had superior adherence to end-tidal carbon dioxide goals and chest compression rate guidelines than extracorporeal cardiopulmonary resuscitation.
使用实际儿科心搏骤停事件的视频记录，评估经典心肺复苏与体外心肺复苏事件中心肺复苏质量的差异。
单中心、前瞻性、观察性试验。
三级儿科教学医院，心脏 ICU。
所有在儿科心脏 ICU 住院并接受持续时间大于 2 分钟的心搏骤停事件的患者，这些事件都被记录在视频中。
无。
纳入 17 个事件，共 264.5 分钟心肺复苏：11 个经典心肺复苏事件（87.5 分钟）和 6 个体外心肺复苏事件（177 分钟）。事件分为 30 秒的时间段，通过视频和遥测数据回顾评估心肺复苏质量标志物：呼气末二氧化碳大于或等于 15mmHg，舒张压大于或等于 30mmHg，每个时间段的胸外按压分数大于 80%，以及每分钟 100-120 次的胸外按压频率。此外，记录并计时每次胸外按压暂停（手离开事件）。与体外心肺复苏相比，经典心肺复苏的时间段更有可能达到呼气末二氧化碳大于或等于 15mmHg（56%比 6.2%；p = 0.01）和提供每分钟 100-120 次的胸外按压（每分钟 112 次比 134 次胸外按压；p < 0.001）。经典心肺复苏和体外心肺复苏在达到舒张压大于或等于 30mmHg 的目标方面没有差异（38%的经典心肺复苏与 30%的体外心肺复苏）。共有 135 次手离开事件：52 次在经典心肺复苏中，83 次在体外心肺复苏中（p = 0.12）。
经典心肺复苏在达到呼气末二氧化碳目标和胸外按压频率指南方面优于体外心肺复苏。
