Lin Jainn-Jim, Kuo Hsuan-Chang, Hsia Shao-Hsuan, Lin Ying-Jui, Wang Huei-Shyong, Hsu Mei-Hsin, Chiang Ming-Chou, Chan Oi-Wa, Lee En-Pei, Lin Kuang-Lin
Division of Pediatric Critical Care and Pediatric Neurocritical Care Center, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Taoyuan, Taiwan.
Front Med (Lausanne). 2022 Jan 28;8:690405. doi: 10.3389/fmed.2021.690405. eCollection 2021.
Transcranial Doppler ultrasound is a sensitive, real time tool used for monitoring cerebral blood flow; it could provide additional information for cerebral perfusion in cerebral resuscitation during post cardiac arrest care. The aim of the current study was to evaluate the utility of a point-of-care transcranial Doppler ultrasound management algorithm on outcomes in pediatric asphyxial out-of-hospital cardiac arrest.
This retrospective cohort study was conducted in two tertiary pediatric intensive care units between January 2013 and June 2018. All children between 1 month and 18 years of age with asphyxial out-of-hospital cardiac arrest and a history of at least 3 min of chest compressions, who were treated with therapeutic hypothermia and survived for 12 h or more after the return of circulation were eligible for inclusion.
Twenty-one patients met the eligibility criteria for the study. Sixteen (76.2%) of the 21 children were male, and the mean age was 2.8 ± 4.1 years. Seven (33.3%) of the children had underlying disorders. The overall 1-month survival rate was 52.4%. Twelve (57.1%) of the children received point-of-care transcranial Doppler ultrasound. The 1-month survival rate was significantly higher ( = 0.03) in the point-of-care transcranial Doppler ultrasound group (9/12, 75%) than in the non-point-of-care transcranial Doppler ultrasound group (2/9, 22.2%).
Point-of-care transcranial Doppler ultrasound group was associated with a significantly better 1-month survival rate compared with no point-of-care transcranial Doppler ultrasound group in pediatric asphyxial out-of-hospital cardiac arrest.
经颅多普勒超声是一种用于监测脑血流的敏感、实时工具；它可为心脏骤停后护理期间脑复苏中的脑灌注提供额外信息。本研究的目的是评估即时检测经颅多普勒超声管理算法对小儿窒息性院外心脏骤停结局的效用。
这项回顾性队列研究于2013年1月至2018年6月在两个三级儿科重症监护病房进行。纳入所有年龄在1个月至18岁之间、有窒息性院外心脏骤停且有至少3分钟胸外按压史、接受治疗性低温治疗且循环恢复后存活12小时或更长时间的儿童。
21名患者符合该研究的纳入标准。21名儿童中有16名（76.2%）为男性，平均年龄为2.8±4.1岁。7名（33.3%）儿童有基础疾病。总体1个月生存率为52.4%。12名（57.1%）儿童接受了即时检测经颅多普勒超声。即时检测经颅多普勒超声组的1个月生存率（9/12，75%）显著高于非即时检测经颅多普勒超声组（2/9，22.2%）（P = 0.03）。
在小儿窒息性院外心脏骤停中，即时检测经颅多普勒超声组与非即时检测经颅多普勒超声组相比，1个月生存率显著更高。
