Extracorporeal Cardiopulmonary Resuscitation (E-CPR) During Pediatric In-Hospital Cardiopulmonary Arrest Is Associated With Improved Survival to Discharge

  • Javier J. Lasa
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Rachel S. Rogers
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Russell Localio
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Justine Shults
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Tia Raymond
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Michael Gaies
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Ravi Thiagarajan
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Peter C. Laussen
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Todd Kilbaugh
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Robert A. Berg
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Vinay Nadkarni
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).
  • Alexis Topjian
    From Texas Children’s Hospital, Houston (J.J.L.); Children’s Hospital of Philadelphia, PA (R.S.R., R.L., J.S., T.K., R.A.B., V.N., A.T.); Medical City Children’s Hospital, Dallas, TX (T.R.); University of Michigan C.S. Mott Children’s Hospital, Ann Arbor (M.G.); Boston Children’s Hospital, MA (R.T.); and Toronto Sick Kids Hospital, Canada (P.C.L.).

書誌事項

タイトル別名
  • A Report from the American Heart Association’s Get With The Guidelines–Resuscitation (GWTG-R) Registry

抄録

<jats:sec> <jats:title>Background—</jats:title> <jats:p>Although extracorporeal cardiopulmonary resuscitation (E-CPR) can result in survival after failed conventional CPR (C-CPR), no large, systematic comparison of pediatric E-CPR and continued C-CPR has been reported.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods and Results—</jats:title> <jats:p> Consecutive patients <18 years old with CPR events ≥10 minutes in duration reported to the Get With the Guidelines–Resuscitation registry between January 2000 and December 2011 were identified. Hospitals were grouped by teaching status and location. Primary outcome was survival to discharge. Regression modeling was performed, conditioning on hospital groups. A secondary analysis was performed with the use of propensity score matching. Of 3756 evaluable patients, 591 (16%) received E-CPR and 3165 (84%) received C-CPR only. Survival to hospital discharge and survival with favorable neurological outcome (Pediatric Cerebral Performance Category score of 1–3 or unchanged from admission) were greater for E-CPR (40% [237 of 591] and 27% [133 of 496]) versus C-CPR patients (27% [862 of 3165] and 18% [512 of 2840]). Odds ratios (ORs) for survival to hospital discharge and survival with favorable neurological outcome were greater for E-CPR versus C-CPR. After adjustment for covariates, patients receiving E-CPR had higher odds of survival to discharge (OR, 2.80; 95% confidence interval, 2.13–3.69; <jats:italic>P</jats:italic> <0.001) and survival with favorable neurological outcome (OR, 2.64; 95% confidence interval, 1.91–3.64; <jats:italic>P</jats:italic> <0.001) than patients who received C-CPR. This association persisted when analyzed by propensity score–matched cohorts (OR, 1.70; 95% confidence interval, 1.33–2.18; <jats:italic>P</jats:italic> <0.001; and OR, 1.78; 95% confidence interval, 1.31–2.41; <jats:italic>P</jats:italic> <0.001, respectively]. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusion—</jats:title> <jats:p>For children with in-hospital CPR of ≥10 minutes duration, E-CPR was associated with improved survival to hospital discharge and survival with favorable neurological outcome compared with C-CPR.</jats:p> </jats:sec>

収録刊行物

  • Circulation

    Circulation 133 (2), 165-176, 2016-01-12

    Ovid Technologies (Wolters Kluwer Health)

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