Dewan Maya, O'Halloran Amanda, Kleinman Monica, Tegtmeyer Ken, Gallagher Regan, Nadkarni Vinay, Sutton Robert M, Wolfe Heather A
Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Division of Critical Care Medicine, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Pediatr Crit Care Med. 2020 Nov;21(11):992-999. doi: 10.1097/PCC.0000000000002488.
To develop a consensus framework that can guide the process of classifying and reviewing pediatric in-hospital cardiac arrest in the PICU.
A three-round electronic Delphi consensus study with an additional in-person session with pediatric resuscitation experts. The modified electronic Delphi consisted of survey questions sent to the expert panel with the goals of (1) achieving consensus on definitions of avoidable, potentially avoidable, and unavoidable PICU in-hospital cardiac arrest and (2) achieving consensus and ranking of a list of factors that contribute to potentially avoidable PICU in-hospital cardiac arrest.
Electronic surveys of resuscitation experts including pediatric critical care, cardiac critical care, emergency medicine, and hospital medicine physicians, nurses, advance practice nurses, and resuscitation researchers.
Not applicable.
Not applicable.
Over three rounds of an electronic Delphi, 24 resuscitation experts participated. In Round 1, consensus was reached for the definitions of potentially avoidable and unavoidable cardiac arrest. Consensus was not reached for avoidable cardiac arrest. In Round 2, the expert panel agreed with seven factors from the literature and achieved consensus on an additional seven factors. Consensus was achieved on the modified definition of avoidable cardiac arrest. In Round 3, participants were asked to rank the contributing factors in order of their importance. For the in-person session, the consensus definitions and contributing factors from the modified electronic Delphi were presented to a multidisciplinary group of pediatric resuscitation experts and reached consensus for all three definitions.
A multidisciplinary group of pediatric resuscitation experts generated a consensus-based framework to classify and review pediatric in-hospital cardiac arrest in the PICU. Future work will focus on the application of this framework and further validation of these definitions and contributing factors for in-hospital cardiac arrest both within and outside the PICU.
制定一个共识框架，以指导儿科重症监护病房（PICU）内儿童住院心脏骤停的分类和审查过程。
三轮电子德尔菲共识研究，并与儿科复苏专家进行一次面对面会议。改良的电子德尔菲法包括向专家小组发送调查问卷，目标是：（1）就可避免、潜在可避免和不可避免的PICU住院心脏骤停的定义达成共识；（2）就导致潜在可避免的PICU住院心脏骤停的一系列因素达成共识并进行排序。
对包括儿科重症监护、心脏重症监护、急诊医学和医院医学的医生、护士、高级实践护士以及复苏研究人员在内的复苏专家进行电子调查。
不适用。
不适用。
在三轮电子德尔菲法中，24名复苏专家参与。在第一轮中，就潜在可避免和不可避免的心脏骤停的定义达成了共识。对于可避免的心脏骤停未达成共识。在第二轮中，专家小组认可了文献中的七个因素，并就另外七个因素达成了共识。就可避免的心脏骤停的修改定义达成了共识。在第三轮中，要求参与者按重要性对促成因素进行排序。在面对面会议上，向多学科的儿科复苏专家小组介绍了改良电子德尔菲法的共识定义和促成因素，并就所有三个定义达成了共识。
一个多学科的儿科复苏专家小组生成了一个基于共识的框架，用于对PICU内儿童住院心脏骤停进行分类和审查。未来的工作将集中在该框架的应用以及对这些定义和促成因素在PICU内外的住院心脏骤停中的进一步验证。
