A Prospective, Population-Based Study of the Epidemiology and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest
This study reports the epidemiologic features, survival rates, and neurologic outcomes of the largest population-based series of pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data. Secondary analysis of data from a prospective, interventional trial of out-of-...
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| Veröffentlicht in: | Pediatrics (Evanston) 2004-07, Vol.114 (1), p.157-164 |
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| creator | Young, Kelly D Gausche-Hill, Marianne McClung, Christian D Lewis, Roger J |
| description | This study reports the epidemiologic features, survival rates, and neurologic outcomes of the largest population-based series of pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data.
Secondary analysis of data from a prospective, interventional trial of out-of-hospital pediatric airway management conducted from 1994 to 1997 (Gausche M, Lewis RJ, Stratton SJ, et al. JAMA. 2000;283:783-790). Consecutive out-of-hospital patients from 2 large urban counties in California 31 minutes in the emergency department.
The 8.6% survival rate after out-of-hospital pediatric cardiopulmonary arrest is poor. Administration of >3 doses of epinephrine or prolonged resuscitation is futile. |
| doi_str_mv | 10.1542/peds.114.1.157 |
| format | Article |
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Secondary analysis of data from a prospective, interventional trial of out-of-hospital pediatric airway management conducted from 1994 to 1997 (Gausche M, Lewis RJ, Stratton SJ, et al. JAMA. 2000;283:783-790). Consecutive out-of-hospital patients from 2 large urban counties in California <12 years old or 40 kg in bodyweight who were determined by paramedics to be pulseless and apneic were included. Main outcome measures included survival to hospital discharge, patient demographics, arrest etiology, arrest rhythm, event intervals, and neurologic outcomes.
In 599 patients, 601 events were studied (54% were <1 year old, 58% were male). Return of spontaneous circulation was achieved in 29%; 25% were admitted to the hospital, and 8.6% (51) survived to hospital discharge. The most prevalent etiologies were sudden infant death syndrome and trauma; these resulted in relatively higher mortality. Respiratory etiologies and submersions followed; these resulted in relatively lower mortality. Twenty-six percent of the arrests were witnessed by citizens, and an additional 8% were witnessed by rescue personnel. Witnessed arrests had a higher survival rate (16%). Thirty-one percent of patients received bystander cardiopulmonary resuscitation, which was not demonstrated to result in improved survival rates. Arrest rhythms were asystole (67%), pulseless electrical activity (24%), and ventricular fibrillation (9%); children with the latter 2 rhythms had better survival rates. One third of the survivors (16 of 51) had good neurologic outcome, none of whom received >3 doses of epinephrine or were resuscitated for >31 minutes in the emergency department.
The 8.6% survival rate after out-of-hospital pediatric cardiopulmonary arrest is poor. Administration of >3 doses of epinephrine or prolonged resuscitation is futile.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.114.1.157</identifier><identifier>PMID: 15231922</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>Elk Grove Village, IL: Am Acad Pediatrics</publisher><subject>Anesthesia ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Anesthesia: equipment, devices ; Biological and medical sciences ; California - epidemiology ; Cardiac arrest ; Cardiopulmonary Resuscitation ; Child ; Child, Preschool ; CPR ; Emergency Medical Services ; Epidemiology ; Epinephrine - administration & dosage ; Evaluation ; Female ; Heart Arrest - epidemiology ; Heart Arrest - etiology ; Heart Arrest - mortality ; Heart Arrest - therapy ; Humans ; Infant ; Infant mortality ; Infant, Newborn ; Male ; Medical sciences ; Outcome Assessment (Health Care) ; Pediatric research ; Pediatrics ; Prospective Studies ; Sudden Infant Death - epidemiology ; Survival Rate ; Sympathomimetics - administration & dosage</subject><ispartof>Pediatrics (Evanston), 2004-07, Vol.114 (1), p.157-164</ispartof><rights>2004 INIST-CNRS</rights><rights>COPYRIGHT 2004 American Academy of Pediatrics</rights><rights>COPYRIGHT 2004 American Academy of Pediatrics</rights><rights>Copyright American Academy of Pediatrics Jul 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c602t-3ea60748b20c85f16d250359c142fe5312a1d4e90e4ee6bd80cb2cf3e505c4483</citedby><cites>FETCH-LOGICAL-c602t-3ea60748b20c85f16d250359c142fe5312a1d4e90e4ee6bd80cb2cf3e505c4483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15925175$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15231922$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Young, Kelly D</creatorcontrib><creatorcontrib>Gausche-Hill, Marianne</creatorcontrib><creatorcontrib>McClung, Christian D</creatorcontrib><creatorcontrib>Lewis, Roger J</creatorcontrib><title>A Prospective, Population-Based Study of the Epidemiology and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>This study reports the epidemiologic features, survival rates, and neurologic outcomes of the largest population-based series of pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data.
Secondary analysis of data from a prospective, interventional trial of out-of-hospital pediatric airway management conducted from 1994 to 1997 (Gausche M, Lewis RJ, Stratton SJ, et al. JAMA. 2000;283:783-790). Consecutive out-of-hospital patients from 2 large urban counties in California <12 years old or 40 kg in bodyweight who were determined by paramedics to be pulseless and apneic were included. Main outcome measures included survival to hospital discharge, patient demographics, arrest etiology, arrest rhythm, event intervals, and neurologic outcomes.
In 599 patients, 601 events were studied (54% were <1 year old, 58% were male). Return of spontaneous circulation was achieved in 29%; 25% were admitted to the hospital, and 8.6% (51) survived to hospital discharge. The most prevalent etiologies were sudden infant death syndrome and trauma; these resulted in relatively higher mortality. Respiratory etiologies and submersions followed; these resulted in relatively lower mortality. Twenty-six percent of the arrests were witnessed by citizens, and an additional 8% were witnessed by rescue personnel. Witnessed arrests had a higher survival rate (16%). Thirty-one percent of patients received bystander cardiopulmonary resuscitation, which was not demonstrated to result in improved survival rates. Arrest rhythms were asystole (67%), pulseless electrical activity (24%), and ventricular fibrillation (9%); children with the latter 2 rhythms had better survival rates. One third of the survivors (16 of 51) had good neurologic outcome, none of whom received >3 doses of epinephrine or were resuscitated for >31 minutes in the emergency department.
The 8.6% survival rate after out-of-hospital pediatric cardiopulmonary arrest is poor. Administration of >3 doses of epinephrine or prolonged resuscitation is futile.</description><subject>Anesthesia</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Anesthesia: equipment, devices</subject><subject>Biological and medical sciences</subject><subject>California - epidemiology</subject><subject>Cardiac arrest</subject><subject>Cardiopulmonary Resuscitation</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>CPR</subject><subject>Emergency Medical Services</subject><subject>Epidemiology</subject><subject>Epinephrine - administration & dosage</subject><subject>Evaluation</subject><subject>Female</subject><subject>Heart Arrest - epidemiology</subject><subject>Heart Arrest - etiology</subject><subject>Heart Arrest - mortality</subject><subject>Heart Arrest - therapy</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant mortality</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pediatric research</subject><subject>Pediatrics</subject><subject>Prospective Studies</subject><subject>Sudden Infant Death - epidemiology</subject><subject>Survival Rate</subject><subject>Sympathomimetics - administration & dosage</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNptkt-LEzEQxxdRvHr66qME4QTBrUk22R-PtZx3QqEF9Tmkyew2R3ZTk6za_94sLfROSh4yk3zmBzPfLHtL8JxwRj_vQYc5IWxOkl89y2YEN3XOaMWfZzOMC5IzjPlV9iqEB4wx4xV9mV0RTgvSUDrLDgu08S7sQUXzGz6hjduPVkbjhvyLDKDR9zjqA3ItijtAt3ujoTfOuu6A5KDReozK9TD9JzN3bX6fkpkoLdqANjJ6o9BSem2mvL0bpD-ghfcQ4uvsRSttgDen-zr7-fX2x_I-X63vvi0Xq1yVmMa8AFniitVbilXNW1JqynHBG0UYbYEXhEqiGTQYGEC51TVWW6raAjjmirG6uM4-HPPuvfs1psKiN0GBtXIANwZRlmVVkIok8P1_4IMb_ZB6E5TWDNOaNAnKj1AnLQgztC56qToYwEvrBmhNel6QRJZ1wVji5xf4dKY5qosBH58EJCbC39jJMQRR362esvklVjlroQORxrhcX2xGpZUHD63Ye9OnlQiCxSQnMclJJDkJkvwqBbw7jWTc9qDP-Ek_Cbg5ATIoaVsvB2XCI66hnFT8XHlnut0f42GqdJRHeGSeK_8Do8Xg7Q</recordid><startdate>20040701</startdate><enddate>20040701</enddate><creator>Young, Kelly D</creator><creator>Gausche-Hill, Marianne</creator><creator>McClung, Christian D</creator><creator>Lewis, Roger J</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>8GL</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20040701</creationdate><title>A Prospective, Population-Based Study of the Epidemiology and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest</title><author>Young, Kelly D ; Gausche-Hill, Marianne ; McClung, Christian D ; Lewis, Roger J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c602t-3ea60748b20c85f16d250359c142fe5312a1d4e90e4ee6bd80cb2cf3e505c4483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Anesthesia</topic><topic>Anesthesia. 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Cell therapy and gene therapy</topic><topic>Anesthesia: equipment, devices</topic><topic>Biological and medical sciences</topic><topic>California - epidemiology</topic><topic>Cardiac arrest</topic><topic>Cardiopulmonary Resuscitation</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>CPR</topic><topic>Emergency Medical Services</topic><topic>Epidemiology</topic><topic>Epinephrine - administration & dosage</topic><topic>Evaluation</topic><topic>Female</topic><topic>Heart Arrest - epidemiology</topic><topic>Heart Arrest - etiology</topic><topic>Heart Arrest - mortality</topic><topic>Heart Arrest - therapy</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant mortality</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Outcome Assessment (Health Care)</topic><topic>Pediatric research</topic><topic>Pediatrics</topic><topic>Prospective Studies</topic><topic>Sudden Infant Death - epidemiology</topic><topic>Survival Rate</topic><topic>Sympathomimetics - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Young, Kelly D</creatorcontrib><creatorcontrib>Gausche-Hill, Marianne</creatorcontrib><creatorcontrib>McClung, Christian D</creatorcontrib><creatorcontrib>Lewis, Roger J</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: High School</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Young, Kelly D</au><au>Gausche-Hill, Marianne</au><au>McClung, Christian D</au><au>Lewis, Roger J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Prospective, Population-Based Study of the Epidemiology and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2004-07-01</date><risdate>2004</risdate><volume>114</volume><issue>1</issue><spage>157</spage><epage>164</epage><pages>157-164</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>This study reports the epidemiologic features, survival rates, and neurologic outcomes of the largest population-based series of pediatric out-of-hospital cardiopulmonary arrest patients with prospectively collected data.
Secondary analysis of data from a prospective, interventional trial of out-of-hospital pediatric airway management conducted from 1994 to 1997 (Gausche M, Lewis RJ, Stratton SJ, et al. JAMA. 2000;283:783-790). Consecutive out-of-hospital patients from 2 large urban counties in California <12 years old or 40 kg in bodyweight who were determined by paramedics to be pulseless and apneic were included. Main outcome measures included survival to hospital discharge, patient demographics, arrest etiology, arrest rhythm, event intervals, and neurologic outcomes.
In 599 patients, 601 events were studied (54% were <1 year old, 58% were male). Return of spontaneous circulation was achieved in 29%; 25% were admitted to the hospital, and 8.6% (51) survived to hospital discharge. The most prevalent etiologies were sudden infant death syndrome and trauma; these resulted in relatively higher mortality. Respiratory etiologies and submersions followed; these resulted in relatively lower mortality. Twenty-six percent of the arrests were witnessed by citizens, and an additional 8% were witnessed by rescue personnel. Witnessed arrests had a higher survival rate (16%). Thirty-one percent of patients received bystander cardiopulmonary resuscitation, which was not demonstrated to result in improved survival rates. Arrest rhythms were asystole (67%), pulseless electrical activity (24%), and ventricular fibrillation (9%); children with the latter 2 rhythms had better survival rates. One third of the survivors (16 of 51) had good neurologic outcome, none of whom received >3 doses of epinephrine or were resuscitated for >31 minutes in the emergency department.
The 8.6% survival rate after out-of-hospital pediatric cardiopulmonary arrest is poor. Administration of >3 doses of epinephrine or prolonged resuscitation is futile.</abstract><cop>Elk Grove Village, IL</cop><pub>Am Acad Pediatrics</pub><pmid>15231922</pmid><doi>10.1542/peds.114.1.157</doi><tpages>8</tpages></addata></record> |
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| subjects | Anesthesia Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anesthesia: equipment, devices Biological and medical sciences California - epidemiology Cardiac arrest Cardiopulmonary Resuscitation Child Child, Preschool CPR Emergency Medical Services Epidemiology Epinephrine - administration & dosage Evaluation Female Heart Arrest - epidemiology Heart Arrest - etiology Heart Arrest - mortality Heart Arrest - therapy Humans Infant Infant mortality Infant, Newborn Male Medical sciences Outcome Assessment (Health Care) Pediatric research Pediatrics Prospective Studies Sudden Infant Death - epidemiology Survival Rate Sympathomimetics - administration & dosage |
| title | A Prospective, Population-Based Study of the Epidemiology and Outcome of Out-of-Hospital Pediatric Cardiopulmonary Arrest |
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