Document Detail


American Heart Association cardiopulmonary resuscitation quality targets are associated with improved arterial blood pressure during pediatric cardiac arrest.
MedLine Citation:
PMID:  22960227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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 4156 CCs. The median mattress corrected depth was 32mm (IQR 28-38); median rate was 111CC/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.
Authors:
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:
Type:  Journal Article     Date:  2012-09-06
Journal Detail:
Title:  Resuscitation     Volume:  84     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-03-07     Completed Date:  2013-09-23     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  168-72     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Blood Pressure*
Cardiopulmonary Resuscitation / standards*
Child
Child, Preschool
Female
Heart Arrest / physiopathology*,  therapy*
Humans
Infant
Male
Practice Guidelines as Topic
Prospective Studies
Societies, Medical
Grant Support
ID/Acronym/Agency:
K23 HD062629/HD/NICHD NIH HHS
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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