| American Heart Association Cardiopulmonary Resuscitation Quality Targets are Associated with Improved Arterial Blood Pressure During Pediatric Cardiac Arrest. | |
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MedLine Citation:
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PMID: 22960227 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIM: To evaluate the association between cardiopulmonary resuscitation (CPR) quality and hemodynamic measurements during in-hospital pediatric cardiac arrest. We hypothesized that AHA recommended CPR rate and depth targets would be associated with systolic blood pressures ≥ 80mmHg and diastolic blood pressures ≥ 30mmHg. METHODS: In children and adolescents<18 years of age who suffered a cardiac arrest with an invasive arterial catheter in place, a CPR monitoring defibrillator collected CPR data which was synchronized to arterial blood pressure (BP) tracings. Chest compression (CC) depths were corrected for mattress deflection. Generalized least squares regression estimated the association between BP and CPR quality, treated as continuous variables. Mixed-effects logistic regression estimated the association between systolic BP ≥ 80mmHg/diastolic BP ≥ 30mmHg and the AHA targets of depth ≥ 38mm and/or rate ≥ 100/min. RESULTS: Nine arrests resulted in 4,156 CCs. The median mattress corrected depth was 32mm (IQR 28-38); median rate was 111 CC/min (IQR 103-120). AHA depth was achieved in 1090/4156 (26.2%) CCs; rate in 3441 (83.7%). Systolic BP ≥ 80mmHg was attained in 2516/4156 (60.5%) compressions; diastolic ≥ 30mmHg in 2561/4156 (61.6%). A rate ≥ 100/min was associated with systolic BP ≥ 80mmHg (OR 1.32; CI(95) 1.04, 1.66; p=0.02) and diastolic BP ≥ 30mmHg (OR 2.15; CI(95) 1.65, 2.80; p<0.001). Exceeding both (rate ≥ 100/min and depth ≥ 38mm) was associated with systolic BP ≥ 80mmHg (OR 2.02; CI(95) 1.45, 2.82; p<0.001) and diastolic BP ≥ 30mmHg (OR 1.48; CI(95) 1.01, 2.15; p=0.042). CONCLUSIONS: AHA quality targets (rate ≥ 100/min and depth ≥ 38mm) were associated with systolic BPs ≥ 80mmHg and diastolic BPs ≥ 30mmHg during CPR in children. |
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Authors:
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Robert M Sutton; Benjamin French; Akira Nishisaki; Dana E Niles; Matthew R Maltese; Lori Boyle; Mette Stavland; Joar Eilevstjønn; Kristy B Arbogast; Robert A Berg; Vinay M Nadkarni |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-5 |
Journal Detail:
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Title: Resuscitation Volume: - ISSN: 1873-1570 ISO Abbreviation: Resuscitation Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0332173 Medline TA: Resuscitation Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012. Published by Elsevier Ireland Ltd. |
Affiliation:
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The Children's Hospital of Philadelphia, Department of Anesthesiology and Critical Care Medicine, 34(th) Street and Civic Center Boulevard, Philadelphia, PA 19104. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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