Association of chest compression pause duration prior to E-CPR cannulation with cardiac arrest survival outcomes. (August 2022)

• Record Type: Journal Article
• Authors: Lauridsen, Kasper G.; Lasa, Javier J.; Raymond, Tia T.; Yu, Priscilla; Niles, Dana; Sutton, Robert M.; Morgan, Ryan W.; Fran Hazinski, Mary; Griffis, Heather; Hanna, Richard; Zhang, Xuemei; Berg, Robert A.; Nadkarni, Vinay M.; Abulebda, Kamal; Atkins, Diane; Balikai, Shilpa; Berg, Marc; Berg, Robert; Bhalala, Utpal; Braga, Matthew S.; Buysse, Corinne; Cheng, Adam; Christoff, Andrea; Corbett, Kelly; DeCaen, Allan; Daniels, Katherine; deJong, Gabry; del Castillo, Jimena; Dewan, Maya; Donoghue, Aaron; Esangbedo, Ivie; Flaherty, Michael; Friess, Stuart; Gangadharan, Sandeep; Gawronski, Orsola; Gilleland, Jonathan; Griffis, Heather; Gray, James; Harvey, Helen; Harwayne-Gidansky, Ilana; Haskell, Sarah; Hayes, Jennifer; Heber, Kiran; Hunt, Betsy; Ikeyama, Takanari; Jani, Priti; Kleinman, Monica; Knight, Lynda; Kurosawa, Hiroshi; Glerup Lauridsen, Kasper; Lemoine, Tara; Maa, Tensing; Masse, Elizabeth; Marina Mejia, Luz; Hui Mok, Yee; Morgan, Ryan; Nadkarni, Vinay; Nett, Sholeen; Niles, Dana; O'Halloran, Amanda; Olson, Michelle; Ong, Gene; Rajapreyar, Prakad; Raymond, Tia; Roberts, Joan; Sen, Anita; Skellet, Sophie; Stromberg, Daniel; Su, Felice; Sutton, Robert; Sweberg, Todd; Tegg, Oscar; Tegtmeyer, Ken; Topjian, Alexis; Van Ittersum, Wendy; Urbano Villaescusa, Javier; Watanabe, Ichiro; Welsby, Denise; Wenger, Jesse; Wolfe, Heather; Yeo, Andrea; Yu, Pricilla;
• Is Part Of: Resuscitation. Volume 177(2022)
• Page Start: 85
• Page End: 92
• Publication Date: 2022-08
• Subjects: Cardiopulmonary resuscitation -- Extracorporeal circulation -- In-hospital cardiac arrest -- Survival -- Chest compression pauses -- Pediatrics; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2022.05.004
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Objective: To characterize chest compression (CC) pause duration during the last 5 minutes of pediatric cardiopulmonary resuscitation (CPR) prior to extracorporeal-CPR (E-CPR) cannulation and the association with survival outcomes. Methods: Cohort study from a resuscitation quality collaborative including pediatric E-CPR cardiac arrest events ≥ 10 min with CPR quality data. We characterized CC interruptions during the last 5 min of defibrillator-electrode recorded CPR (prior to cannulation) and assessed the association between the longest CC pause duration and survival outcomes using multivariable logistic regression. Results: Of 49 E-CPR events, median age was 2.0 [Q1, Q3: 0.6, 6.6] years, 55% (27/49) survived to hospital discharge and 18/49 (37%) with favorable neurological outcome. Median duration of CPR was 51 [43, 69] min. During the last 5 min of recorded CPR prior to cannulation, median duration of the longest CC pause was 14.0 [6.3, 29.4] sec: 66% >10 sec, 25% >29 sec, 14% >60 sec, and longest pause 168 sec. Following planned adjustment for known confounders of age and CPR duration, each 5-sec increase in longest CC pause duration was associated with lower odds of survival to hospital discharge [adjusted OR 0.89, 95 %CI: 0.79–0.99] and lower odds of survival with favorable neurological outcome [adjusted OR 0.77, 95 %CI: 0.60–0.98]. Conclusions: Long CC pauses were common during the last 5 min of recorded CPR prior to E-CPR cannulation. Following adjustment for age and CPR duration, each 5-second incremental increase in longest CC pause duration was associated with significantly decreased rates of survival and favorable neurological outcome.